Medicine Through Time (Western Front 3)

Question 1

Why were there issues relating to treatment of the injured?

Answer 1

• the contaminated conditions made aseptic surgery impossible. Shrapnel, dirt, and bits of uniform in wounds caused infection
• The sheer number of casualties often meant the system struggled to cope

Question 2

What were the three methods of dealing with infection?

Answer 2

• Debridement
• Carrel- Dakin method
• Amputation

Question 3

What is debridement?

Answer 3

the removal of dead or infected tissue

Question 4

What was the Carrel-Dakin method?

Answer 4

using a sterilised salt solution in the wound through a tube (antiseptics like carbolic acid didn’t work on gas gangrene).

Question 5

What was amputation and how many men had lost limbs by 1918?

Answer 5

removing infected limbs, 240,000 men

Question 6

What was the Thomas Splint?

Answer 6

A large splint designed to keep limbs and joints still during surgery

Question 7

Why did many men die from shrapnel wounds to the legs?

Answer 7

because the leg was not kept
rigid during transfer from the frontline to a CCS, leading to blood loss and infection.

Question 8

How did the Thomas Splint improve survival rates from leg injuries?

Answer 8

Improved survival rates from leg injuries from 20% to 82%

Question 9

What were the issues with X-rays?

Answer 9

• X-rays couldn’t identify all objects in the body e.g. fragments of clothing
• X-rays took several minutes, a lot of time for a wounded man to keep still
• X-ray machines could only be used for an hour before they overheated

Question 10

What were mobile X-ray units?

Answer 10

vans loaded with X-ray equipment, at the back

Question 11

Who developed Blood transfusions on the Western Front?

Answer 11

Robertson, A canadian doctor. He used a syringe and tube to transfer blood from the donor to the patient.

Question 12

Where were blood transfusions carried out?

Answer 12

In base hospitals, and by 1917, in Casualty Clearing Stations

Question 13

Who designed a portable blood transfusion kit and why?

Answer 13

Geoffrey Keynes, a British doctor in the RAMC, designed a portable blood
transfusion kit so that transfusions could be carried out near the frontline.

Question 14

What did Richard Lewisohn discover?

Answer 14

In 1915, he discovered that adding sodium nitrate to blood stopped it clotting and that blood with sodium nitrate could be stored for up to 2 days if refrigerated.

Question 15

In 1916, what did Rous and Turner discover?

Answer 15

That adding citrate glucose solution allowed blood to be stored for up to 4 weeks

Question 16

What happened in the Battle of Cambrai, relating to blood?

Answer 16

An american doctor built a carrying case for bottles of donated blood, he treated 20 severely wounded soldiers during the battle, to which 11 survived

Question 17

Why were blood banks important?

Answer 17

because they made blood more easily available on the frontline, meaning badly injured soldiers were more likely to survive.

Question 18

What percentage of British wounds were to the head, face and neck?

Answer 18

20%

Question 19

Why were brain injuries usually fatal towards the start of the war?

Answer 19

because unconscious/confused patients were difficult to move through the chain of evacuation, and very few doctors had experience of neurosurgery.

Question 20

Who developed new brain surgery techniques by observing and experimenting?

Answer 20

Harvey Cushing

Question 21

What was local anaesthetic?

Answer 21

numbing the area being operated on

Question 22

What was general anaesthetic?

Answer 22

Putting the patient to sleep

Question 23

What did Harvey Cushing do?

Answer 23

• He used a magnet to remove metal fragments from the brain
• He used local anaesthetic rather than general anaesthetic, because general anaesthetic swelled the brain

Question 24

Who developed methods of restoring and and rebuilding destroyed facial features?

Answer 24

Harold Gillies

Question 25

What new operations did Gillies devise to overcome problems?

Answer 25

• using skin grafts (taking skin from one area to graft onto the wounded area)
• using jaw splints, wiring and metal replacement cheeks for facial reconstruction

Question 26

In total, how many plastic surgery operations were carried out throughout the war?

Answer 26

12,000

Question 27

By 1915, how many hospitals in France specialised in plastic surgery, especially for head injuries?

Answer 27

7

Question 28

After the battle of the Somme, how many cases of facial damage did Gillies personally deal with?

Answer 28

2,000