Surgery: Phase 5 Government action and war 1905-1920 Flashcards
What problems were there during the First World War on surgery?
Halted medical research - WWI halted medical research as resources were diverted to winning the war. 14,000 doctors were taken from their normal work.
Infection - Battlefields were incredibly dirty and most methods were only effective in clean operating theatres
Numbers - The sheer number of casualties was overwhelming. The Somme saw 1 million alone.
How did WWI improve blood loss?
In the 1910s, it was discovered that adding anticoagulant and refrigerating the blood was successful for storing it.
Hustin, who used sodium citrate as an anticoagulant performed the first non-direct transfusion in 1914.
The need to stockpile blood led to the discovery that you could separate plasma and cells. Cells could be bottled, packed in ice and stored. He established the first blood bank in 1917.
How were X-rays improved in WWI?
Marie Curie used her own money to equip ambulances with X-ray equipment.
The International Red Cross made her head of its Radiological Service and she ran the training courses
What were the limitations to progress with X-rays?
X-rays could not be used to detect fragments of clothing within a wound.
The patient had to remain still while the X-rays were taken - a problem if the soldier was in pain
The glass tubes overheated so they could not be continuously used.
High doses of radiation could cause burns.
How were there improvements with fighting infection during WWI?
Prevention of infection was difficult. Operations and bacteria on clothing often caused gangrene.
They eventually discovered to cut away the infected tissue and soaking the wound in a saline solution.
What were the limitations to improvements in fighting infection?
Excision and debridement to cut away tissue and carrel-Dakin salt solution cleaning method were time consuming and often the only solution was amputation.
What was the Thomas Splint and how did it help?
The Splint forced the wound to stay still which reduced the chance of infection
In 1914, 80% of soldiers with a broken femur died. In 1916, 80% lived.
What was skin grafting and how was it developed?
Harold Gillies was tasked with dealing with facial injuries caused by shrapnel. He did this through skin grafts.
He opened a specifically-designed hospital in Sidcup, treating 200,000 patients after the Battle of the Somme alone.
Facial reconstruction became an important part of the post-war healing process.
How were prosthetic limbs developed during WWI?
Over 240,000 soldiers lost a limb.
Prostheses became much more advanced and they were made of lighter metal alloys and had more advanced mechanisms.
What were the limitations to prosthetic limbs?
They took time to make and there were long waiting lists
Patients had to be taught to use it effectively which took a long time.
How was brain surgery developed during WWI?
American neurosurgeon, Harvey Cushing, experimented with using magnets to draw out pieces of metal from wounds.
He found success in using this on brain injuries.
He also found that using local anaesthetics did not cause the brain to swell like general anaesthetics did.
