WW1 Medicine Flashcards
What was the Western Front
Area in Belgium and France where the Allies fought Germany from 1914-1918
What was the RAMC
Royal Army Medical Corps
What was FANY
First Aid Nursing Yeomanry Corps
Chain of evacuation system
First aid close to front line given at regimental aid posts (RAPs)
Dressing stations collected men from RAPs
Casualty Clearing Stations (CCSs) were for serious injuries
Base hospitals - in real buildings, effectively normal hospitals
Role of stretcher bearers
Transport wounded through relay posts until they reached a medical post or a transport link
What were the main areas of advancement for medicine in WW1
Plastic surgery
Blood transfusions
X-rays
Why was the Ypres Salient the scene of many battles
It was the way to ports of Calais and Dunkirk (Germans wanted to capture these ports to cut off British supplies)
Why was the Ypres Salient vulnerable
Germans had higher ground - could see Allied movements and build defences
What was Hill 60
Man made hill where British used tunnelling and mines to blow up the hill
When was the first battle of Ypres
October - November 1914
Significance of second battle of Ypres
First use of chlorine gas by Germans
When did second battle of Ypres take place
April - May 1915
When did third battle of Ypres take place
July - November 1917
What was the Ypres Salient
Area around Ypres in Belgium where many battles took place
When was the battle of the Somme
July - November 1916
On the first day of the Somme how many British casualties and deaths were there
60,000 casualties and 20,000 dead
In total at the Battle of the Somme, there were ___ casualties
What was the result of this
400,000
Enormous pressure on medical services
When was the Battle of Arras
April 1917
What was the system below Arras
Network of tunnels (made easy by chalky ground)
Rooms created with running water and electricity
Hospital
The underground tunnels at Arras were used for…
Safety
Hospital
Allowing troops to front line in secrecy
When was the Battle of Cambrai
October 1917
What happened at the Battle of Cambrai
450 tanks used by Allies to launch surprise assault
Not enough infantry support - British lost the ground they’d taken
Front line trench
Nearest enemy
Where soldiers would shoot / enter no man’s land from
Command trench
10-20m behind firing line
Support trench
200-500m behind front line
Reserve trench
100m behind support trench
Reserve troops here to mount counterattack if enemy entered front line
Communication trench
Linked front line with command, support + reserve trenches
Why was it difficult to move through trenches with wounded
They contained equipment and men
How did communication impact helping the wounded
Communication about wounded difficult, especially during major battles
Why was it dangerous to collect wounded from No Man’s Land
Under fire
Muddy conditions
Trench fever was transmitted by
Body lice
Symptoms of trench fever
Flu-like symptoms
High temp, headache, shivering, aching muscles
Treatment of trench fever
Drugs trialled eg quinine without success
Passing electrical current through affected area was used effectively
Prevention of trench fever
By 1918 cause had been identified as lice
Clothes disinfected
Delousing stations set up
Impact of trench fever
Impacted nearly half a million men
Cause of trench foot
Mud and waterlogged trenches
Symptoms of trench foot
Painful swelling in feet
Tight boots added to problem - restricted blood flow
Gangrene would set in later
Gangrene definition
When body tissue decomposes due to loss of blood supply
Treatment of trench foot
Soldiers advised to clean and dry feet
Amputation in worst cases
Prevention of trench foot
Changing socks and keeping feet dry
Rubbing whale oil into feet to protect them
Impact of trench foot
Winter 1914-15 over 20,000 men affected
Cause of shell-shock
Stressful conditions of war
Symptoms of shell-shock
Tiredness, nightmares, headaches
Uncontrollable shaking
Mental breakdown
Treatment of shell-shock
Not well understood in WW1
Mainly prescribed rest
Some received treatment back in Britain
Impact of shell-shock
Estimated 80,000 troops experienced it
Some accused of cowardice + shot
Shrapnel definition
Hollow shell filled with steel balls or lead, with gunpowder and a time fuse
Features of rifles
Automatic rapid fire rather than one bullet at a time
Bullets pointed so drove deeper into body
Features of machine guns
Faster than rifles
500 rounds a minute
Devastated attacking forces
Bullets would pierce organs and fracture bones
Features of artillery
Cannons —> bigger + more powerful
Bombardments continuous, could last weeks or months
Artillery fire = half of all casualties
Features of shrapnel
Exploded mid air above enemy
Effective against troops advancing across No Man’s Land
Most cases = injured arms and legs
Shells and shrapnel were responsible for what % of wounds
58%
Features of chlorine gas
First used 1915 (Germans)
Death by suffocation
July 1915 gas masks given to British troops
Before this urination on handkerchiefs
Features of phosgene gas
First used 1915 (Germans)
Faster acting than chlorine but similar effects
Kill exposed person within 2 days
Features of mustard gas
First used 1917 (Germans)
Odourless
Worked in 12 hours
Blisters + burned skin through clothing
Gas was the cause of less than __% of British deaths
5%
Sufferers of gas were given…
Oxygen
Why was gas not used regularly as a weapon
Hard to target particular place with it
What were the stages of the evacuation route
Stretcher bearers
Regimental aid post
Field ambulance and dressing station
Casualty clearing station
Base hospitals
Each battalion had how many stretcher bearers?
16
How many men did it take to carry a stretcher
4
Define triage
A system of splitting the wounded into groups according to who needed the most urgent attention
What was a field ambulance
Large mobile medical unit with medical officers, support staff and nurses
What kinds of facilities did base hospitals have
Operating theatres
X-ray departments
Specialist areas for gas poisoning
From the base hospital where were most patients sent
Back to Britain in hospital trains
By Nov 1915 how many motor ambulances were there in France
250
Ambulance ___ were introduced to carry up to ___ casualties
Trains
800
How many were wounded in the first 3 days of the Battle of Arras
Over 7000
The Arras hospital had what kind of facilities
700 beds
Operating theatres
All medical officers belonged to…
The RAMC
How did membership of RAMC increase
9000 in 1914
113,000 in 1918
Initially the nurses on the front line were…
Well-trained Queen Alexandra’s nurses
How did the attitude towards volunteer nurses change
Initially turned away by govt
Attitude changed as number of casualties increased
The work of FANY volunteers could involve
Professional nursing in operating theatres
Cleaning
Ambulance drivers
Carrying supplies to front
Driving motorised kitchens to supply food
By 1900, most operations were carried out using
Aseptic methods
Why was it not possible to carry out aseptic surgery on the western front
Treatment needed to be portable
Define gas gangrene
Infection that produces gas in gangrenous wounds
Why was infection likely
Wounds exposed to soil containing fertiliser
Define debridement
Cutting away of dead, damaged and infected tissue around the wound
What were 3 methods for treating infection
Debridement
Carrel-Dakin method
Amputation
Carrel-Dakin method
Using sterilised salt solution in the wound through a tube
Disadvantages of Carrel-Dakin method
Solution only lasted 6 hours
Had to be made as it was needed - difficult at times of high demand
By 1918, how many men had lost limbs?
240,000
Men with a gunshot or shrapnel wound had a __% chance of survival in 1915
20%
Why was the survival rate for gunshot / shrapnel wounds so low in 1915
The wounds created a compound fracture
Particularly dangerous when thigh bone (femur) fractured - damaged muscle + caused major bleeding into thigh
When did the Thomas splint start being used
From 1916
What was the Thomas Splint
New type of splint for wounded limbs
Stopped two joints moving
How did the Thomas splint impact survival rate
Went from 20% to 82%
What were x-rays used for
Locating bullets and shrapnel
What were the problems with x-rays on the western front
Couldn’t detect all objects in the body (some items eg clothing were unnoticed until the operation)
Had to stay still for several mins
Tubes fragile + overheated quickly - had to cool down after 1 hour
The solution to x-rays overheating was
To use three machines in rotation
How many mobile x-ray units operated in the British sector
6
What was a mobile x-ray unit
Portable x-ray unit that could be moved around western front in a truck
Advantage of mobile x-ray unit
X-ray unit could go to the battle rather than wait for soldiers to be transported
Disadvantage of mobile x-ray units
Quality of x-rays not as good but sufficient to locate bullets / shrapnel
The first experiments in blood transfusion were performed in ___ by ___
1819
James Blundell
Define blood transfusion
Blood taken from a healthy person and given to another person
Problems with early use of blood transfusions
Donor had to be present as blood could not be stored
Blood clotted and blocked tube
Danger of infection
Who designed the portable blood transfusion kit
Geoffrey Keynes
What year were blood transfusions used at base hospitals from
1915
What year blood transfusions used at casualty clearing stations from
1917
What was discovered in 1915 to help the problem of storing blood
Adding sodium citrate allowed blood to be stored + clotting prevented
What was discovered in 1916 that helped solve problem of storing blood
Adding citrate glucose solution allowed blood to be stored for up to 4 weeks
Define general anaesthetic
Putting a patient to sleep during an operation
Define local anaesthetic
Area being operated numbed to prevent pain - patient awake
Stored blood was used at which 1917 battle
Battle of Cambrai
How was brain surgery developed
Magnet to remove metal fragments
Local anaesthetic instead of general - prevented brain from swelling and decreased risks
How was plastic surgery developed?
Harold Gillies worked on facial reconstruction
Skin grafts developed - skin taken from other part of body + used to repair wound
Two features of dressing stations
Treat minor injuries so soldiers could return to front line; more serious injuries treated further down chain
Staffed by medical officers and stretcher bearers - after 1915 also nurses
Two features of casualty clearing stations
Had operating theatres, x-ray machines and hospital wards, allowing more advanced treatment for major injuries
Normally several miles behind front lines - ensured safety of wounded soldiers
