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WW1 Hospitals (Part 3)

User AvatarPosted by Sue Daniels at 10/11/2014 11:55:15
Battlefield Medicines

Having read my earlier pieces on the 1WW, one of our colleagues sent me a message describing the death of his great uncle in the war. The extract below is from the book Silent Night telling the events around the Christmas truce of 1914.  It describes the death of his Great Uncle on Christmas Eve 1914.


“Although both sides seemed reluctant to fire, hidden snipers, seemingly beholden to nothing but their vocation, assured a certain level of wariness.  That morning Rifleman A. R. Bassingham of the 5th London Rifles, standing too tall, took a shot to the head. The British had, as yet, no helmets.  Formerly a tenor in a music hall group in civilian life, he had been counted upon for Christmas carolling.  Instead, recalled Graham Williams, he was collected by stretcher-bearers after dark – a reminder that Christmas was also for Killing.”


This set me to look at the progress of battlefield medicine during the war.


As this poignant extract mentions, soldiers only had caps for the first year of the war. Head wounds were a common cause of mortality as soldiers suffered terrible wounds from explosions and snipers.  After some time, the army realised they needed to respond to the advancing weaponry and the Brodie helmet was invented and became standard issue in 1915. This steel helmet gave the British soldier the classic look we often associate with the 1WW.  The machine gunners at the Battle of the Somme could fire 600 rounds a minute. High velocity rounds wreaked havoc with the body, twisting tissue and splintering bone. Fighting on farmland fertilised by manure meant that wounds quickly became infected; gangrene was rife.


The pathway to treatment started with stretcher bearers taking casualties to first aid posts where they were then taken in motorised ambulances to casualty clearing stations. They were then taken by train to a base hospital. This took 24 – 48 hours but by 1915 the British military medical machine moved closer to the front line. Casualty clearing stations became better equipped and crucially, surgeons moved closer to the battlefield . Fewer delays in receiving lifesaving treatment led to significant improvements  in survival.  The French gathered data in the first world war which led to the concept of the ‘Golden Hour’ where seriously injured soldiers needed to be treated within 60 minutes.


The British Army began the routine use of blood transfusion in treating wounded soldiers. Blood was transferred directly from one person to another. But it was a US doctor, Captain Oswald Robertson, who realised the need to stockpile blood before casualties arrived. He established the first blood bank on the Western Front in 1917, using sodium citrate to prevent the blood from coagulating and becoming unusable. Blood was kept in ice for up to 28 days and then transported to casualty clearing stations for the use of life saving surgery where it was needed most.


Some innovations had a massive impact on mortality. At the beginning of the war, 80% of soldiers with a broken femur died. A pioneering welsh surgeon Hugh Owen Thomas invented the Thomas splint to secure the broken leg. By 1916, 80% of soldiers survived this injury.


As we know today, cleanliness and hygiene are key weapons in preventing the spread on infection. Military hospitals and soldiers accommodation were very squalid. The trenches were freezing and full of mud. For those soldiers fighting in Gallipoli and Africa,  malaria was a frequent companion. Trench fever was common on the western front but this was in fact typhus carried by lice. Over the years, more hygienic practices became adopted in base hospitals. Today heavily infected wounds are rarely seen due to the discovery of antibiotics in 1928. However, our understanding of the treatment of wounds owes much to the experimentation with antiseptics in the First World War. The Carrel - Dakin technique which delivered sodium hypochlorite directly to damaged tissue beds  in deep wounds, came to be viewed as best practice.   


I hope you had a thoughtful remembrance weekend

WW1 Hospitals (Part 2)

Posted by Sue Daniels at 06/11/2014 20:03:40

WWI Dartford (Part 1)

Posted by Sue Daniels at 04/11/2014 16:37:34