Medicine: Western Front Case Study Flashcards
when did Britain declare war on Germany?
4th August 1914
how many British casualties were there on the Western Front during the war?
2.7 million
what % of the casualties were not seen by medical services due to them dying or being held prisoner?
25%
what % of those treated died of their wounds?
5.6%
when was the first battle of Ypres?
1914
how many troops did Britain lose in the first battle of Ypres?
50,000
what was the salient?
an area under British control surrounded by Germans on 3 sides
how did the Germans have an advantage over the British in the first battle of Ypres?
they held hill 60 meaning they had a height advantage
how did the British capture hill 60 in 1915?
they mined underneath the hill and literally blew up the German defences
when was the second battle of Ypres?
April to May 1915
what did the Germans use for the first time during the second battle of Ypres?
chlorine gas
how many troops did the British lose in the second battle of Ypres?
59,000
during what battle did the British finally push back the Germans from the town of Ypres?
Passchendaele
how many British casualties were there in the battle of Passchendaele?
245,000
when was the battle of the Somme?
July to November 1916
how many British casualties were there on the first day the the battle of the Somme?
20,000
how many British casualties were there throughout the battle of the Somme?
57,000
what 2 reasons make the battle of the somme significant?
first use of tanks
use of creeping barrage
what is creeping barrage?
artillery bombardment that moved towards the German trench as the British approached it
when was the battle of Arras?
1917
how was the attack at Arras initially a British success?
the British advanced 8 miles into enemy territory
what did Britain, New Zealand and Canada built during the battle of Arras?
2.5 miles of tunnels which could shelter 25,000 men, contained accommodation, a railway, water and electrical supplies
when was the battle of Cambrai?
1917
how many British tanks were used during the battle of Cambrai?
over 450
how did the British lose the battle of Cambrai?
the Germans counter-attacked and all land was taken
what were the first trenches made out of?
sandbags in existing ditches
how did trenches develop as the war went on?
they became more complex with bunkers, drainage, hospitals and accommodation
in a trench, what was the firebay?
where troops did their shooting protected by sandbags
in a trench, what was the duckboard?
prevented soldiers standing in water and getting trench foot
in a trench, what was the firestep?
allows the soldiers to fire towards the other trench
in a trench, what was the parapet?
low protective wall
in a trench, what was the ammunition shelf?
area in which ammo was kept near the firestep
in a trench, what was the dugout?
area dug into side of the trench where men could take protective cover
what was the frontline trench?
where attacks were made from, the most dangerous area
what was the reserve trench?
100m behind the support trench where troops would be mobilised to counter attack the enemy if they captured the front line
what was the support trench?
80m behind the frontline trench, troops would retreat here if under attack
what was the communications trench?
trenches that run between other trenches linking them together
what were the advantages of the trench system?
simple to make and cheap to build
easy to defend with few men
provided some shelter
what were the disadvantages of the trench system?
very dirty and unhygienic
dead bodies left horrible smell
bad weather led to flooding
how many cases of frostbite was there in december 1914?
6000
why was it difficult to transport wounded men from the front line?
the landscape was very muddy and uneven meaning ambulances would get stuck
large number of casualties made it hard to manoeuvre stretchers
land was dangerous under heavy fire
why were horse drawn carriages not very useful?
could not cope with the number of wounded
shaky transport made injuries worse
how many motor ambulances was money raised for?
512
when did the first motor ambulances reach the front line?
october 1914
why were ambulance trains useful?
they were specially designed to fit stretchers down the side of the carriage and some contained operating theatres
why were ambulance trains criticised?
for damaging the war effort as trains were blocking supply routes in France and Belgium
what problems were facing soldiers on the western front?
weather, slow transport, lack of resources, lack of medical staff, gas attacks
what caused trench foot?
standing in waterlogged trenches with no change of boots or socks
what would happen in the first stage of trench foot?
feet would swell, go numb and the skin would turn red or blue
how many cases of trench foot did the british army experience during the winter of 1914-15?
12000
what were the attempted solutions for trench foot?
soldiers should carry 3 pairs of socks and change them twice daily
attempts were made to pump out trenches to reduce water logging and add duckboards
what were the symptoms of trench fever?
high temperature, headache, aching muscles, eye pain rash, back pain, joint pain
what spread trench fever?
lice
how many men on the western front were affected by trench fever?
half a million
what were the attempted solutions for trench fever?
delousing stations where clothes were disinfected and men were bathed and sprayed with chemicals
what were the symptoms of shell shock?
tiredness, headaches, nightmares, loss of speech, uncontrollable shaking and complete mental breakdown
how many british troops experienced shell shock?
80,000
what was the army’s code for shell shock?
NYD,N (not yet diagnosed, nervous)
what were the solutions for shell shock?
men were accused of cowardice and were punished, some even shot
by how much did the brodie helmet reduce fatal head wounds?
by 80%
what % of shrapnel wounds were to the arms and legs?
60%
how many men had limbs amputated due to shrapnel wounds?
over 41,000
how quickly could as gangrene kill?
in one day
what could artillery, gunfire and bombs do to soldiers?
break bones, pierce vital organs and destroy tissue
how did most injuries get infected?
due to bacteria in the soil that had previously been used for agriculture
how was the impact of gangrene reduced?
tetanus injections from the end of 1914
what % of wounds were high explosive shells and shrapnel responsible for?
58%
what % of wounds were bullets responsible for?
39%
how many soldiers died from gas attacks during WW1?
6000
what 3 types of gas were used during WW1?
chlorine, phosgene and mustard
how did chlorine gas affect soldiers?
caused death by suffocation
how did soldiers try to avoid breathing in chlorine gas?
soaked cotton pads in urine and pressed them to their faces
how did phosgene gas affect soldiers?
faster than chlorine gas
often kill within 2 days of exposure
how did mustard gas affect soldiers?
odourless that worked within 12 hours
caused internal and external blisters that could pass through clothing to burn skin
from when were soldiers given gas masks?
July 1915
when were xrays discovered?
1895 by william roentgen
how earl were xray departments set up?
1896
what happened in the xray department of Birmingham General hospital in 1896?
dr john hall edwards was one of the first doctors to use an xray to tolerate a needle in a woman’s hand
what were the problems with early xrays?
radiation levels were 1500x stronger than today so patients could lose hair or suffer burns
machine contained a glass tube which was very fragile
xrays took around 90 mins to complete
who did the first human to human blood transfusions?
James Blundell
what did Karl Landsteiner discover in 1901?
blood groups - O was the universal blood group
what was the major problem with the first blood transfusions?
blood could not yet be stored so had to be used straight away and donor had to be connected directly to recipient
what was antiseptic surgery?
killing germs in wounds
what was aseptic surgery?
preventing germs from reaching wounds
what did aseptic surgery include?
all medical equipment was steam sterilised
air in room was steam sterilised
all medical staff had to wash and wear gowns and gloves
who laid the foundations for aseptic surgery?
Lister
who were the RAMC?
the Royal Army Medical Core
what were the RAMC responsible for?
medical care and providing treatment to the sick and wounded soldiers
keeping men healthy
how much did the RAMC increase during WW1?
1914 - 9000 men
1918 - 113,000 men
how many well trained nurses were there in the RAMC throughout WW1?
1914 - 300
1918 - 10,000
who were FANY?
the First Aid Nursing Yeomanry
what was FANY?
the first women’s voluntary organisation to send volunteers to the western front
what were FANY responsible for?
driving ambulances and supplies to the front line
setting up mobile bath units which could bathe up to 40 men per hour
what were the features of the regimental aid post?
located within 200m of the front line in communications trenches
gave immediate first aid and get as many men back to fighting as quickly as possible
led by regimental medical officer
what were the features of the advanced dressing station?
within 400m of the RAP
what were the features of the main dressing station?
1/2 mile away from the RAP
what were the features of the ADS and MDS?
only looks after men for 1 week
staffed by 10 medical officers
could deal with around 150 men
what were the features of the casualty clearing stations?
7 miles away from the front
has several doctors
contained operating theatres and wards
deal with up to 1000 casualties at a time
treated most critical injuries close to the front
what was the CCS triage system?
walking wounded - patch them up and send them back to the front
those in need of hospital treatment - send to a base hospital
no chance of recovery - make them comfortable
what were the features of base hospitals?
situated near the ports on the French/ Belgian coast
operating theatres, xrays, labs, specialist centres
could treat up to 2500 patients at once
what was the arras underground hospital?
a fully working hospital built in 800m of tunnels
what were the features of the arras underground hospital?
waiting rooms for the wounded 700 spaces for stretchers to be used as beds an operating theatre a mortuary electricity and water supply
when and why was the underground hospital abandoned?
during the battle of arras in 1917 when its water supply was destroyed by a shell
by 1918, how many men had lost limbs?
240,000
what was wound excision?
cutting away the dead, damaged or infected tissue around wound to reduce infection
what was the carrel dakin method?
putting sterilised salt solution into a wound through a tube
what was the problem with carrel dakin method?
the solution only lasted for 6 hours and had to be made as soon as it was needed
who invented the thomas splint?
hugh thomas
why was the thomas splint better than the previously used splints?
it kept the leg straight until the bone healed correctly
from when were the medical practitioners on the front trained to use the thomas splint?
december 1915
by how much did the thomas splint increase survival rates?
from 20%-80%
how were mobile xray units used?
2 xrays would be taken from different angles to help the surgeon identify the location and shape of the shrapnel
how many mobile vans were used throughout the british sector of the western front?
6
what were the mobile vans nicknamed?
petit curies after Mary Curie who invented them
what were the weaknesses of the mobile xray vans?
could not detect all objects in body
took long time to perform xray
tubes in xray overheated quickly so could only be used one an hour
took a while to set up and picture quality was poor
who introduced blood transfusions to the British sector?
Lawrence Robertson in 1915 at the base hospital at Boulogne
what method of blood transfusion did Robertson use?
the human to human method to prevent shock of blood loss
who designed the portable blood transfusion kit?
Geoffrey Keynes
why was the portable blood transfusion kit useful?
it could store blood used to take closer to the front line meaning soldiers received blood sooner stopping their bodies going into shock
what did Richard Lewisohn find in 1915?
adding sodium citrate to blood stopped it clotting so it could be stored
what did Francis Rous and James Turner find in 1916?
adding a citrate glucose solution to blood meant it could be kept refrigerated for up to 4 weeks
how many units of blood did Oswald Robertson store in preparation for the battle of cambrai in 1917?
22 units
how many Canadians were treated using the 22 units of blood?
20
how many of the Canadians survived?
11
what % of all injuries on the western front were to the head, neck and face?
20%
what techniques of brain surgery did Cushing develop?
use of magnets to remove metal fragments from brain
used local anaesthetic instead of general anaesthetic to avoid brain swelling
how many patients did Cushing operate on in 1917 and what % survived?
45 patients, 71% survived compared to usual survival rate of 50%
why did some CCS become specialist brain surgery centres?
men who were operated on quickly were more likely to survive
who developed the use of plastic surgery during the war?
Harold Giles
which plastic surgery hospital opened in Kent in 1917?
Queens Hospital
what methods did Giles use for plastic surgery?
using skin grafts - taking skin from one area to graft onto the wounded area
using jaw splints, wiring and metal replacement cheeks
how many cases did Giles personally deal with after the battle of the somme?
2000
by 1915, how many hospitals in France specialised in plastic surgery?
7
how many plastic surgery operations were carried out during the war?
12000
what was a blighty wound?
a wound which is serious enough to get the soldier away from fighting but not fatal or crippling
