UNSEEN AMBULANCE SERVICE

OFFICIAL AMBULANCE RULES & STANDARD OPERATING PROCEDURES

THIS ISN'T ANOTHER FIVEM CITY. THIS IS UNSEEN.

Department: Unseen Ambulance Service (UAS)
Model: UK NHS Ambulance Service
Version: 1.0
Applies to: All ambulance staff, trainees, paramedics, supervisors and clinical command

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1. PURPOSE OF THE AMBULANCE SERVICE

The Unseen Ambulance Service exists to provide realistic, professional and compassionate emergency medical care throughout the city.

Our aim is to create meaningful medical roleplay based on the standards and principles of UK ambulance services.

Ambulance personnel are not simply there to revive players and return them to gameplay.

They are expected to assess injuries, communicate with patients, deliver appropriate treatment, make clinical decisions and arrange hospital care where required.

Patient safety, dignity and realistic medical roleplay must always come first.

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2. PROFESSIONAL CONDUCT

2.1 – Professionalism

All ambulance personnel must behave professionally while on duty.

Staff must remain calm, respectful and compassionate, even when dealing with challenging patients or stressful situations.

2.2 – Equality of Treatment

All patients must receive impartial care regardless of:

• Criminal history.
• Gang affiliation.
• Employment.
• Personal relationships.
• Disagreements with ambulance staff.
• Whether they are police officers, criminals or civilians.

2.3 – No Refusal of Care as Punishment

Ambulance staff must not refuse treatment because they dislike a patient or disapprove of their actions.

Treatment may be delayed or withdrawn from an unsafe scene until appropriate safeguards are in place.

2.4 – Abuse of Position

Ambulance staff must not use their role to access confidential information, restricted locations, medications or equipment for personal benefit.

2.5 – Remaining In Character

Medical personnel must maintain realistic roleplay throughout their duties.

Unnecessary OOC conversations, joking about serious injuries or deliberately rushing scenes are not acceptable.

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3. AMBULANCE SERVICE RANK STRUCTURE

Unseen will use a UK-inspired clinical and operational structure.

Role	Responsibility
Student Paramedic	Training and supervised patient care
Emergency Care Assistant (ECA)	Supporting ambulance crews
Emergency Medical Technician (EMT)	Patient assessments and care within approved competence
Paramedic	Independent assessment and treatment within scope
Specialist Paramedic	Advanced clinical responsibilities
Advanced Paramedic	Advanced assessment and clinical leadership
Operational Team Leader	Staff and incident supervision
Duty Operations Manager	Operational oversight
Head of Ambulance Service	Department leadership

Clinical qualifications and operational seniority are separate.

Having a management rank does not automatically give someone greater medical qualifications.

Staff may only perform treatments and procedures for which they are trained and authorised.

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4. STARTING & ENDING DUTY

4.1 – Starting Duty

Before responding to incidents, staff must:

1. Sign on duty.
2. Wear the correct uniform.
3. Ensure their radio is working.
4. Check their assigned ambulance or response vehicle.
5. Confirm the required medical equipment is available.
6. Update their operational availability.

4.2 – Ambulance Crewing

Emergency ambulances should preferably operate with two qualified or appropriately supervised crew members.

Single-crewed response may be permitted for trained personnel in approved response vehicles.

A solo responder must not attempt activities requiring additional trained personnel or equipment.

4.3 – Ending Duty

Before signing off, staff must:

• Complete or hand over active patient care.
• Finish relevant patient records.
• Restock medical equipment.
• Return or secure departmental vehicles.
• Notify control of their availability change.

Patients must not be abandoned because someone wants to finish their shift.

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5. EMERGENCY CALLS & DISPATCH

Unseen will use a simplified version of the NHS ambulance response categories.

Category 1 – Life-Threatening Emergency

Examples include:

• Cardiac arrest.
• Respiratory arrest.
• Unconscious patients with immediately life-threatening conditions.
• Catastrophic bleeding.

These incidents require the highest response priority.

Category 2 – Emergency

Examples include:

• Suspected stroke.
• Suspected heart attack.
• Significant trauma.
• Serious breathing difficulties.
• Serious injuries requiring urgent assessment.

Category 3 – Urgent

Examples include:

• Moderate injuries requiring assessment.
• Stable patients needing further treatment.
• Non-immediately life-threatening medical concerns.

Category 4 – Less Urgent

Examples include:

• Minor injuries.
• Stable patients who require non-emergency assistance.
• Appropriate patient transport requests.

Clinical urgency must determine response priority, not the identity or status of the patient.

The categories are based on the NHS Ambulance Response Programme, but Unseen will not impose unrealistic real-world response targets on a small FiveM server.

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6. RESPONDING TO EMERGENCIES

6.1 – Emergency Driving

Ambulance drivers must operate within their training and the realistic capabilities of their vehicles.

Emergency lights and sirens do not remove the responsibility to drive safely.

6.2 – Road Safety

Drivers must consider:

• Traffic.
• Pedestrians.
• Road conditions.
• Junctions.
• Vehicle handling.
• Weather.
• The condition of any patient being transported.

6.3 – GTA Driving Is Prohibited

Ambulance staff must not:

• Launch ambulances over jumps.
• Drive up unrealistic mountain routes.
• Use pavements recklessly.
• Ignore significant collisions.
• Deliberately crash through obstacles.
• Drive dangerously simply to reach a call faster.

6.4 – Vehicle Collisions

Significant collisions involving ambulance vehicles must be roleplayed and reported.

A damaged or unsafe ambulance must not continue transporting patients.

6.5 – Emergency Response Qualifications

Only appropriately trained and authorised personnel may undertake emergency response driving.

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7. ARRIVING AT A SCENE

7.1 – Scene Assessment

Before approaching a patient, crews must consider whether the scene is safe.

Potential hazards include:

• Weapons.
• Ongoing violence.
• Traffic.
• Fire.
• Hazardous materials.
• Unstable vehicles.
• Unsafe buildings.
• Environmental dangers.

7.2 – Scene Safety

Ambulance personnel must not knowingly enter an active violent scene without appropriate safeguards.

Where necessary, crews should request police or fire service assistance.

7.3 – Police Scene Clearance

Police may manage criminal threats or public safety hazards.

However, ambulance personnel retain responsibility for their clinical decisions.

A police officer does not have authority to dictate medical treatment simply because they are managing the incident.

7.4 – Establishing Patient Contact

Once safe, staff should:

1. Introduce themselves.
2. Assess responsiveness.
3. Identify immediate life-threatening concerns.
4. Establish the patient's presenting complaint.
5. Begin an appropriate clinical assessment.
6. Explain the proposed care where possible.

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8. PATIENT ASSESSMENT

8.1 – Assess Before Treatment

Patients must not automatically receive a revive or treatment interaction without appropriate assessment.

The required assessment should be proportionate to the patient's condition.

8.2 – Primary Survey

For seriously ill or injured patients, crews should use a structured primary survey such as DR ABC or an appropriate ABCDE approach within their training.

This includes considering:

• Danger.
• Response.
• Airway.
• Breathing.
• Circulation.
• Disability or neurological concerns.
• Exposure and environmental factors.

8.3 – Secondary Assessment

Where appropriate, staff should investigate:

• Mechanism of injury.
• Pain and symptoms.
• Medical history.
• Medications.
• Allergies.
• Relevant observations.
• Changes in condition.

8.4 – Communication

Staff must explain what they are doing where reasonably possible.

Patients should be given opportunities to describe symptoms and participate in their care.

8.5 – No Instant Diagnosis

Ambulance personnel must not automatically diagnose every injury simply by looking at a patient.

Assessment findings should reasonably support the clinical roleplay.

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9. MEDICAL TREATMENT & REVIVAL

9.1 – Treatment Must Match the Injury

Care should reflect the type and severity of the patient's condition.

Examples include:

• Wound assessment and management.
• Appropriate bleeding control.
• Monitoring observations.
• Immobilisation or movement precautions where indicated.
• Pain management within training.
• Resuscitation roleplay where appropriate.
• Transport for further care.

9.2 – Revive Mechanics

A revive command or script interaction represents a gameplay mechanic, not a complete medical procedure.

Staff must incorporate appropriate medical roleplay before and after using it.

9.3 – No Revive and Run

Staff must not arrive, immediately revive a patient and leave without meaningful assessment or communication.

9.4 – Clinical Limitations

Paramedics may only perform procedures, administer medications or make clinical decisions within their approved scope.

Advanced treatments require the appropriate qualifications and authorisation.

9.5 – Treatment Time

Medical scenes should be detailed enough to feel realistic but must not be deliberately prolonged without purpose.

There is no mandatory five- or ten-minute treatment timer for every patient.

The complexity of the scene should reflect the medical circumstances.

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10. INJURY ROLEPLAY

10.1 – Serious Injuries Have Consequences

Gunshot wounds, stab wounds, significant falls and high-speed vehicle collisions should be treated as potentially serious injuries.

10.2 – Realistic Recovery

Patients who suffer significant injuries should not automatically return to demanding physical activities immediately after hospital treatment.

10.3 – Medical Advice

Paramedics should explain appropriate recovery limitations.

The roleplay must remain proportional and should not involve inventing arbitrary restrictions simply to control another player's character.

10.4 – Returning to Criminal Scenes

Ambulance staff must not intentionally facilitate patients immediately returning to an active gunfight after suffering serious injuries.

10.5 – Continuity of Injuries

Patients and medical personnel should consider previous injuries where relevant to ongoing roleplay.

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11. PATIENT CONSENT & CAPACITY

11.1 – Patient Consent

Where a patient has capacity, medical personnel should obtain valid consent before examination and treatment.

11.2 – Refusal of Treatment

A patient with decision-making capacity may refuse treatment, even if medical personnel believe that refusal is unwise.

A refusal must be roleplayed appropriately and relevant information explained.

11.3 – Capacity Concerns

Staff should consider decision-making capacity where a patient is unconscious, confused, severely intoxicated or otherwise unable to make a particular decision.

11.4 – Emergency Treatment

Where a patient lacks capacity and urgent treatment is necessary, medical staff should follow the applicable best-interests principles represented within Unseen's medical framework.

11.5 – No Forced Outcomes

Ambulance personnel must not force permanent disabilities, irreversible character changes or permanent character death onto another player without the required consent and approved server procedures.

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12. TRANSPORTING PATIENTS

12.1 – Transport Decisions

Not every patient requires transport to hospital.

Transport should depend on assessment findings, risks, available care pathways and the patient's decisions where applicable.

12.2 – Stretcher Use

Patients who cannot reasonably walk or move independently should be transferred using appropriate equipment and roleplay.

Staff must not make seriously injured patients sprint to an ambulance.

12.3 – Safe Transport

Drivers must consider the patient's condition.

Reckless driving, unrealistic shortcuts and unnecessary high-speed manoeuvres are prohibited.

12.4 – En-Route Monitoring

Where required, an attending crew member should monitor the patient and continue appropriate care.

12.5 – Hospital Handover

Where relevant, crews must provide a structured handover covering:

• Patient details.
• Presenting complaint or mechanism of injury.
• Relevant findings.
• Observations.
• Treatment provided.
• Changes in condition.
• Outstanding concerns.

An ATMIST-style handover may be used for trauma cases.

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13. HOSPITAL ROLEPLAY

13.1 – Hospital Is Part of Medical RP

Hospital treatment should not simply consist of placing a patient on a bed and instantly restoring their health.

13.2 – Medical Role Boundaries

Ambulance staff must remain within their role and qualifications.

Being a paramedic does not automatically qualify someone to act as a surgeon or specialist hospital doctor.

13.3 – Hospital Staffing

If Unseen introduces hospital doctors, nurses and other medical roles, these should have their own training requirements and procedures.

13.4 – Medical Discharge

Patients should receive realistic discharge advice relevant to their injuries.

Discharge does not automatically mean immediate and complete recovery.

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14. POLICE & AMBULANCE INTERACTIONS

14.1 – Medical Care Comes First

Injured suspects must receive appropriate medical assessment and treatment.

Police must not pressure ambulance crews to rush care simply to complete an arrest.

14.2 – Police Custody

Where a detained person requires medical attention, officers must arrange appropriate care.

14.3 – Medical Authority

Qualified medical personnel determine clinical treatment within their competence.

Police remain responsible for lawful custody, safety and security arrangements.

14.4 – Patient Confidentiality

Medical staff must not automatically disclose confidential patient information to police.

Disclosure must be justified by consent or an appropriate legal or safeguarding basis.

14.5 – Criminal Evidence

Ambulance personnel must not deliberately destroy evidence, but their primary responsibility remains patient care.

They should avoid unnecessary interference with potential evidence.

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15. NON-COMBATANT STATUS

15.1 – Ambulance Personnel Are Neutral

On-duty ambulance staff must not participate in criminal conflicts or police-versus-criminal combat.

15.2 – No Taking Sides

Staff must not deliberately favour a gang, police officer or civilian based on personal relationships.

15.3 – No Criminal Activity on Duty

On-duty personnel must not:

• Assist robberies.
• Transport criminals to evade police.
• Conceal illegal property for criminals.
• Supply restricted equipment.
• Act as lookouts.
• Provide confidential information to criminal organisations.

15.4 – Staff Safety

Ambulance staff must not deliberately place themselves in dangerous situations under the assumption that their medical role makes them invulnerable.

15.5 – No Exploiting Medical Roles

Players must not use ambulances, medical uniforms or on-duty privileges to bypass criminal consequences or access restricted locations.

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16. PATIENT CONFIDENTIALITY

16.1 – Confidential Information

Medical information must be handled professionally.

16.2 – Prohibited Disclosure

Staff must not:

• Share patient records with friends.
• Provide medical information to gangs.
• Discuss confidential treatment in public.
• Reveal information for entertainment or gossip.
• Access records without a legitimate reason.

16.3 – Permitted Disclosure

Information may be shared where appropriate consent, lawful authority, patient safety or safeguarding responsibilities justify it.

16.4 – Medical Records

Patient records must be accurate and must not be altered to conceal misconduct or benefit another player.

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17. DEATH & PRONOUNCEMENT

17.1 – Death Is a Serious Outcome

Death must not be treated as an ordinary inconvenience or automatic outcome of every serious injury.

17.2 – Assessment

Where a patient is unresponsive or appears deceased, staff must follow the appropriate assessment and resuscitation policies represented within Unseen.

17.3 – Recognising Death

Only appropriately trained and authorised personnel may verify death under the city's medical framework.

Verification of death must be distinguished from the formal medical certification of its cause.

17.4 – Permanent Character Death

Permanent character death is governed by Unseen's character death policy.

Medical personnel must not independently force permanent death on another player's character.

17.5 – Police Involvement

Where a death is suspicious, unexpected or potentially criminal, police must be informed and the relevant scene procedures followed.

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18. MASS CASUALTY INCIDENTS

18.1 – Major Incidents

Large incidents involving multiple patients require coordination and prioritisation.

18.2 – Triage

Patients must be prioritised according to clinical urgency rather than player status or relationships.

18.3 – Incident Command

A designated ambulance incident commander should coordinate medical resources where staffing permits.

18.4 – Interagency Cooperation

Ambulance, police and fire services must communicate effectively while respecting their respective responsibilities.

18.5 – Casualty Management

Staff should consider:

• Immediate threats.
• Scene safety.
• Number of casualties.
• Available resources.
• Triage.
• Treatment priorities.
• Transport requirements.
• Hospital capacity.

18.6 – No Rushing Mass Revives

Multiple patients should not be revived simultaneously without individual assessment and appropriate triage roleplay.

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19. MEDICAL RECORDS & REPORTS

19.1 – Patient Care Records

Significant medical encounters should be documented through the approved medical system.

19.2 – Required Information

Records should include, where relevant:

• Patient identity.
• Call details.
• Presenting complaint.
• Injury or illness information.
• Assessment findings.
• Treatment.
• Transport or non-transport decision.
• Handover information.

19.3 – Accurate Records

Staff must not fabricate observations, treatments or diagnoses.

19.4 – Serious Incident Reports

Significant clinical incidents, accidents involving service vehicles, major complaints and serious professional concerns must be reported to a supervisor.

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20. TRAINING & QUALIFICATIONS

20.1 – Initial Training

All recruits must complete relevant training before independent deployment.

Training should cover:

• Professional conduct.
• Communication.
• Scene safety.
• Primary assessments.
• Basic clinical roleplay.
• Consent.
• Patient handling.
• Ambulance equipment.
• Radio use.
• Clinical records.
• Medical confidentiality.
• Emergency driving rules.

20.2 – Supervised Practice

Students and trainees must practise under appropriate supervision.

20.3 – Advanced Clinical Skills

Advanced procedures require additional training and approval.

20.4 – Specialist Qualifications

Additional qualifications may include:

• Emergency response driving.
• Advanced paramedic practice.
• Major incident management.
• Specialist rescue support.
• Clinical supervision.

20.5 – Ongoing Development

Staff may be asked to complete refresher training or assessments.

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21. MANAGEMENT & DISCIPLINARY PROCEDURES

21.1 – Department Accountability

All staff are accountable for their professional behaviour and adherence to the SOPs.

21.2 – Potential Misconduct

Examples include:

• Deliberately refusing treatment without justification.
• Breaching patient confidentiality.
• Unsafe driving.
• Neglecting patients.
• Performing unauthorised medical procedures.
• Falsifying records.
• Abusing service vehicles or equipment.
• Criminal activity while on duty.
• Unprofessional or discriminatory behaviour.
• Repeatedly rushing or disrupting medical RP.

21.3 – Disciplinary Action

Depending on severity, consequences may include:

1. Informal guidance.
2. Formal warning.
3. Additional training.
4. Temporary restriction of clinical privileges.
5. Suspension.
6. Demotion.
7. Removal from the ambulance service.

21.4 – Complaints

Patient and staff complaints must be reviewed fairly and with appropriate consideration of the available evidence.

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22. THE UNSEEN MEDICAL STANDARD

Before making a decision, ambulance personnel should consider:

• Is the scene safe?
• What is wrong with the patient?
• What assessment is appropriate?
• Am I trained and authorised to provide this care?
• Have I obtained appropriate consent?
• Is hospital transport necessary?
• Am I respecting the patient's dignity?
• Have I documented the encounter appropriately?
• Am I contributing to meaningful and realistic roleplay?

Every patient deserves the same professional standard of care.

A criminal deserves treatment.

A police officer does not receive special privileges.

A minor injury should not automatically become a dramatic emergency.

A serious injury should not be instantly forgotten.

We want ambulance roleplay to involve realistic decisions, patient interaction and medical consequences.

The ambulance service is not a revive service. It is an essential part of Unseen's living, breathing community.

THIS ISN'T ANOTHER FIVEM CITY.

THIS IS UNSEEN.