Nightingale, Simpson and Lister

Question 1

What hospital did Nightingale work at during the Crimean war?

Answer 1

The Barrack Hospital in Scutari

Question 2

What was the military view on women nurses?

Answer 2

That they shouldn’t exist kek

Question 3

How did Nightingale reduce the death rate in the Barrack Hospital?

Answer 3

She made sure that all wards were clean and hygienic, all water supplies were adequate and that all patients were fed properly and that wards were ventilated

Question 4

By what percentage did Nightingale reduce the death rate at the Barrack Hospital?

Answer 4

From 42% to 2% (40%)`

Question 5

What book did Nightingale write and when was it published

Answer 5

“Notes on Nursing” (1859)

Question 6

When was the Crimean War?

Answer 6

1853-1854

Question 7

What did “Notes on Nursing” contain?

Answer 7

An emphasis on the need for hygiene and a professional attitude, and was a standard textbook for generations of nurses

Question 8

How many nurses did Nightingale travel with to Scutari?

Answer 8

38

Question 9

How did Nightingale’s fame change nursing?

Answer 9

• The public raised £44,000 to help train nurses
• The “Nightingale School of Nursing” in St Thomas’
  Hospital was established by Nightingale herself
• Nurses were given 3 years of training before they
  could qualify. Discipline and attentiveness were
  important
• By 1900 there were 64,000 trained nurses in Britain
• In 1919, The Nurses Registration Act was passed,
  making training compulsory for all nurses

Question 10

How many trained nurses in Britain were there by 1900?

Answer 10

64,000

Question 11

What hospital did Nightingale establish herself?

Answer 11

The Nightingale School of Nursing

Question 12

What was the Nurses Registration Act and when was it passed?

Answer 12

It was an act that made training compulsory for all nurses, passed in 1919

Question 13

What natural drugs were used as anaesthetics before later discoveries?

Answer 13

Alcohol, Opium and Mandrake
(Relatively ineffective)

Question 14

Which chemist identified Nitrous oxide as an anaesthetic in 1799 but was ignored by surgeons?

Answer 14

Humphrey Davy

Question 15

How did Simpson discover the anaesthetic properties of chloroform?

Answer 15

While looking for a safe alternative to Ether (another anaesthetic with more side effects) that could be used on pregnant women
- One evening he was experimenting by inhaling different chemicals, once he inhaled chloroform, he went unconscious

Question 16

When did Simpson discover the effects of chloroform?

Answer 16

1847`

Question 17

Who was James Simpson?

Answer 17

A professor of Midwifery at Edinburgh University

Question 18

How did chloroform become widely used?

Answer 18

After Queen Victoria gave birth to her 8th child while using chloroform in 1854, and she legalised its use, leading to its usage becoming more accepted

Question 19

What was a negative side effect of chloroform?

Answer 19

It was lethal in high doses, and killed a perfectly healthy 15y/o girl (Hannah Greener) in 1848

Question 20

What was ether?

Answer 20

A substance with anaesthetic qualities, except that it was hard to inhale, (and caused vomiting) an irritant and fairly explosive

Question 21

What were the benefits of anaesthetics?

Answer 21

Longer and more complex operations could be carried out, as unconscious patients were easier to work on

Question 22

What was “The Black Period of Surgery”?

Answer 22

The period between 1846 and 1870 where the death rate among patients increased despite anaesthetics being discovered, as attempts at complicated surgeries led to greater deaths.

Question 23

What problem remained despite the discovery of anaesthetics?

Answer 23

• There was a higher death rate via infection, due to
  the longer operating times, as many surgeons didn’t
  know that poor hygiene spread disease. Operating instruments were also unwashed and dirty, and many surgeons wore the same coats for years, covered in dry pus and blood from previous operations

Question 24

When was “The Black Period of Surgery”?

Answer 24

1846 - 1870

Question 25

What are antiseptic methods of surgery?

Answer 25

Methods that are used to kill germs that get near a wound

Question 26

What are aseptic methods of surgery?

Answer 26

Methods that are used to prevent any germ getting near a wound

Question 27

Which scientist showed that doctors could reduce the spread of infection by washing their hands with chloride of lime?

Answer 27

Ignaz Semmelweis

Question 28

What was a disadvantage of using chloride of lime to prevent the spread of infection?

Answer 28

It was very unpleasant

Question 29

Describe the work of Lister

Answer 29

He initially saw carbolic acid used in sewage works to keep down the smell, and began trying this in operating theatres and saw that it reduced infection rates. Lister then heard about the Germ Theory in 1865 and realised that germs could be in the air, on surgical equipment and on surgeons’ hands and began using carbolic acid on instruments and bandages. The use of antiseptics reduced death rates from 50% in 1864-66 to 15% in 1867-70

• his work led to the introduction of aseptic surgery. This meant that even more germs were removed from the operating theatre, with the aim of creating a totally germ-free environment.

Question 30

Describe how the use of antiseptics decreased death rates in the 19th century

Answer 30

It decreased from 50% in 1846-1864 to 15% in 1870

Question 31

Which scientist invented surgical gloves and when did they invent them?

Answer 31

William Halsted in 1889

Question 32

Describe any advances in aseptic surgery in the 1800s

Answer 32

• Instruments were carefully sterilised before use
  (Usually with high temperature steam)
• Theatres were kept scrupulously clean and fed with
  sterile air
• William Halsted invented surgical gloves in 1889, and theatre staff began sterilising their hands before entering, and wearing gowns, masks, gloves and hats

Question 33

Why was surgery mostly avoided before the 19th century?

Answer 33

• They were very painful
• Most surgery was done quickly to minimise pain
• Anaesthetics were often used but they were dangerous, so complex operations
  couldn’t be carried out, and were too painful.
• Patients often died from blood loss

Question 34

When was ether first used as an anaesthetic, and who was it used by?

Answer 34

1842 by William Clark

Question 35

Describe the opposition to anaesthetics

Answer 35

• Some army surgeons thought that patients should just endure the pain #ALPHA🐺🐺🐺
• Some religious people thought that pain suffered during surgery was God’s will, e.g. the
  pain suffered during childbirth was a woman’s punishment for the original sin

Question 36

Describe how Lister tested his theory after finding about the Germ Theory

Answer 36

He tested his ideas on a boy called James Greenless, with a fractured leg
Instead of an amputation, Lister healed the fracture and the wound wasn’t infected
Lister published these results, as well as 10 other patients’ surgeries in 1857, validating Pasteur’s Germ Theory

Question 37

How could War have influenced advancements in surgery?

Answer 37

The ongoing Crimean war brought about a larger variety of injuries, and war provided test cases for surgeons to try out their new techniques

Question 38

How were doctors required to receive a license?

Answer 38

By being trained at the college of physicians

• Reduced the prominence of quacks, which would have made diagnosis and treatments
  more accurate, as a larger proportion of doctors would have been adequately
  educated, and would therefore be able to provide an expert level treatment etc

Question 39

Describe the effect of the London college of surgeons

Answer 39

Established in 1800 - Provided training + set standards for trainee surgeons. By providing adequate training, the surgeons produced would have a better understanding of surgery and ways to perform it, which would reduce the risk for their patients, as better trained surgeons are more likely to have a good idea of what they’re doing

Question 40

problems with Listers discoveries

Answer 40

• he didn’t fully understand microbes, he thought there was only one
• he wore normal clothes during surgeries

Question 41

disadvantages of ether

Answer 41

had side effects that irritated the eyes and lungs, causing coughing and sickness

Question 42

what was the “Black period” of surgery?

Answer 42

When procedures were longer and more complicated, infections could develop deeper within the body and there could be more blood loss. The number of deaths from surgery may have increased between the 1850s and 1870s. This is known as the ‘black period’ of surgery.

Question 43

what were hospitals like in the early 19th century

Answer 43

• few toilets and poor sewerage systems
• overcrowded wards with lack of fresh air
• a lack of cleanliness, which lead to the spread in infection

Question 44

what signs of development were there in hospital care by the end of the 19th century

Answer 44

• there was an increase in small cottgage hospitals and voluntary hospitals, which were paid for by charity from the wealthy
• After 1867, many workhouses contained an infirmary to treat the sick and the elderly
• Hospitals where patients could be isolated, known as fever hospitals, were established for those suffering with infectious diseases such as smallpox and scarlet fever. Their aim was to treat those suffering while separating them from the general public.

Question 45

what did John Snow discover in 1848 which could help control the dosage of anaesthetic

Answer 45

inhaler

Question 46

examples of aseptic surgery

Answer 46

• the thorough cleaning of operating theatres before and after surgery
• the frequent cleaning of other areas of a hospital
• surgeons wearing sterilised gowns, masks and gloves
• all surgical instruments being sterilised using steam