Medicine on the Western Front Flashcards

1
Q

What was the problem with horse drawn ambulances?

A
  • Artillery shells and bombs destroyed many roads making them unusable
  • men were shaken about making their injuries worse
  • it was very slow and often lead to capture
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2
Q

Why were motor ambulances eventually used?

A

public donations

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3
Q

Why did the British revert to using horse drawn ambulances even after receiving funding for motor ones?

A

The motor ones couldn’t operate in muddy conditions

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4
Q

How many horses were used in the muddiest conditions?

A

6 instead of the usual 2

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5
Q

When did the first ambulance train arrive?

A

October 1914

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6
Q

What did the RAMC use before the ambulance train arrived?

A

French cargo trains

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7
Q

What did the most advanced ambulance trains have?

A

Operating theatres

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8
Q

What were the advantages of barge ambulances over train?

A
  • harder targets for the Germans

- allowed wounded to bypass Base Hospital and be taken straight back to Britain

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9
Q

What were the 3 main injuries / diseases / illnesses on the western front?

A

Trench foot
Trench fever
Shellshock

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10
Q

What were the symptoms of trench foot?

A

Painful swelling of the feet caused by standing in cold mud and water. In the 2nd stage, gangrene set in

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11
Q

Define gangrene

A

the decomposition of body tissue due a loss of blood supply

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12
Q

What was the solution for trench foot?

A

Preventions and if gangrene developed, amputation of the leg

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13
Q

What were the preventions for trench foot?

A

Keeping feet dry
Regularly changing socks
rubbing whale oil into feet

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14
Q

What were the main symptoms of trench fever?

A

Flu like symptoms with high temperature, headache and aching muscles

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15
Q

Why was trench fever a major problem?

A

It affected half a million men on the western front

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16
Q

What was the approach to defeating trench fever?

A

In 1918 when it the cause was identified with lice delousing stations were set up

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17
Q

What was the effect of delousing stations?

A

The numbers experiencing trench fever declined

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18
Q

What were the symptoms of shellshock?

A

tiredness, headaches, nightmares, loss of speech, uncontrollable shaking and complete mental breakdown

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19
Q

What was shellshock later identified as?

A

PTSD

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20
Q

How many british troops experienced shellshock?

A

80,000

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21
Q

What were the treatment methods for shellshock?

A

Treatment back in britain for major cases

Some soldiers were accused of cowardice and punished - some were even shot

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22
Q

Why could minor wounds lead to death?

A

the soil was filled with rich fertiliser that carried bacteria that could cause gangrene infections

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23
Q

When was the brodie helmet introduced?

A

1915

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24
Q

What was the effect of the brodie helmet?

A

Reduced head wounds by 80%

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25
Q

What was the previous alternative to the brodie helmet?

A

a flat cap

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26
Q

When was chlorine gas first used?

A

April-May 1915, Second Battle of Ypres by the Germans

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27
Q

What were the effects of chlorine gas?

A

death by suffocation

28
Q

What were the original gas masks made of?

A

Cotton pads soaked with urine pressed to soldier’s faces

29
Q

When were gas masks introduced?

A

1915

30
Q

When was phosgene gas first used?

A

end of 1915, near Ypres

31
Q

What were the effects of phosgene gas?

A

similar to chlorine (death by suffocation) but was faster acting, killing an infected person within 2 days

32
Q

When was mustard gas first used?

A

July 1917 by the Germans

33
Q

What were the effects of mustard gas?

A

internal and external blisters and could pass through clothing to burn skin

34
Q

Why was mustard the most effective gas?

A

It was odourless and worked within 12 hours

35
Q

What was the chain of evacuation?

A
Aid posts
Dressing stations
Casualty clearing stations
Ambulance units
Base hospitals
36
Q

The first trenches were built in a hurry and weren’t at all advanced. How were they improved over time?

A
  • Steps added: decrease number of accidents

- Drains added: reduced water and mud in trenches; reduced amount of trench foot cases

37
Q

Where were all medical workers from initially?

A

The RAMC, however over time volunteers such as those from FANY were allowed.

38
Q

What were the roles of medical volunteers on the Western Front?

A

The FANY and other volunteers were mainly tasked with:

  • Driving ambulances
  • Cooking
  • Cleaning
39
Q

What do FANY and RAMC stand for?

A
  • First Aid Nursing Yeomanry

- Royal Army Medical Core

40
Q

There was a hospital at Arras. What was special about it?

A
  • Underground hospital
  • Very close to to front line in tunnels underneath town
  • Space for 700 beds, operating theatre, and a mortuary.
  • Running water and electricity
41
Q

What problems did the RAMC and FANY face on the Western Front?

A
  • Stretcher-bearers and horse-wagons were the only option in difficult terrain
  • Many roads and railways had been destroyed
  • Constant fire made recovery of injured difficult
  • Initially, no motor ambulances were sent and there weren’t enough horses to cope.
42
Q

How many motor ambulances did the government buy?

A

512

43
Q

Problems with early x-rays

A
  • Photography was at an early stage- taking x-rays required complete stillness for a long time
  • High doses of radiation released- patients burnt + lost hair
  • Large machines = too heavy to be moved easily
44
Q

When were mobile x-ray units used?

A

After 1914. Before this, static x-rays were used at base hospital and some casualty clearing stations.

45
Q

Benefits of mobile x-rays

A
  • Numbers increased as war went on

- Used closer to the front- faster diagnosis

46
Q

Drawbacks of mobile x-rays

A
  • Images weren’t as clear as static x-rays, but they still prevented many deaths
47
Q

How did blood transfusions begin?

A

1600s: Animal to human transfusions; very low survival rate

48
Q

How did blood transfusions develop before 1900?

A

1818-1829: James Blundell performs first human to human transfusions.

49
Q

Problem with James Blundell’s blood transfusions

A

Blood had to be transferred directly from donor to recipient as it couldn’t be stored. Around half of the recipients survived.

50
Q

How did blood transfusions develop before WW1, at the beginning of the 20th century?

A

1901: Karl Landsteiner discovered three blood groups
1902: His colleagues found a fourth blood group. They found that blood transfusions only worked between people of the same blood group.

51
Q

When were blood transfusions used on the Western front?

A

From 1915 onwards. Limited due to no method of blood storage.

52
Q

What happened in 1915 that improved blood transfusions?

A

Richard Lewisohn found that sodium citrate could be added to blood to stop it from clotting, so could be stored for a short time- a week.

53
Q

How was the development of 1915 (blood transfusions) initially improved?

A

Richard Weil used fridges to store the sodium citrate treated blood for much longer- a few weeks.

54
Q

What happened in 1916 that revolutionised blood transfusion capabilities?

A

Francis Rous and James Turner added citrate glucose which allowed blood to be stored for far longer- for months.

55
Q

When were the newly improved blood storage methods utilised?

A

Battle of Cambrai, 1917- Oswald Hope Robertson stored 22 units of blood to treat Canadian soldiers suffering shock due to blood loss. This demonstrated its potential.

56
Q

Aseptic conditions before 1900 generally

A
  • Operating theatres + wards thoroughly cleaned
  • Surgeons and nurses wore sterilised clothing
  • Sterilised cloths covered surfaces and equipment
  • Surgeons and nurses wore masks to prevent breathing germs into a wound
57
Q

Aseptic conditions before 1900- specific developments

A
  • 1878- Robert Koch develops steam steriliser for surgical instruments
  • 1887 onwards- All surgical instruments sterilised
  • 1890- Anyone touching the patient wore rubber gloves to prevent germs from hands passing to wounds/instruments
58
Q

What was an issue at Dressing and Casualty Clearing Stations?

A

Antiseptic and aseptic surgery was impossible, and many wounds were already infected by the time when patients were operated on.

59
Q

Due to the issue at Dressing and Casualty Clearing Stations, what did surgeons revert to?

A

They went back to using chemicals to kill bacteria but this didn’t work against gas gangrene.

60
Q

When did the Carrel-Dakin method begin to be used and what was it?

A
  • By 1917

- Sterilised salt solution passed through wound using tubes. More effective than chemicals.

61
Q

When did the Carrel-Dakin method not work and what was the solution to this?

A

When infections were too deep. Surgery was developed to remove the damaged and infected tissue as well as to remove all traces of the bullet/shrapnel.

62
Q

What was the final solution if the previous methods didn’t work at curing infection?

A

Amputation.

63
Q

How many soldiers died due to broken legs before December 1915?

A

80%

64
Q

What was used from December 1915 onwards?

A

The Thomas Splint. It kept the leg rigid which reduced blood loss, meaning that the death rate from broken bones decreased to under 20%.

65
Q

How did plastic surgery improve?

A

The large number of facial injuries meant that surgical techniques had to be developed. These developments were led by Harold Gillies, who worked at Queen’s Hospital in Kent.