First Aid in WW1


First Aid

  • Dealing with wounds based around batallions - each one had a medical officer and stretcher basers
  • 16 men minimum allocated this duty 
  • Medical officers had to establish a first aid post usually just behind front lines
  • Wounded would be transferred from here to dressing stations where ambulance teams then provided the inital care. 
  • From dressing stations they would then be transported to field hospitals or clearing stations.
  • Depending on severity of the wounds treatment could be carried out at the field hospitals or sent to other designated hospitals if it was more serious.
  • Dedicated hospital trains and ships were in place for the wounded
  • Royal Army Medical Corps oversaw all of the medical organisation for the BA.
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Shrapnel Wounds - Gillies and Surgery

  • Many shrapnel wounds were to the faces of soldiers leading to them being disfigured.
  • Harold Gillies was employed by the army and he experimented with an early form of plastic surgery.
  • He utilised a method known as the forhead flap - it took cartilage from the ribs and implanted it into the forehead. This could be molded over time to reconstuct facial function and features. 
  • However he did make mistakes - it was experimental, but he learned from it and made many improvements.
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Treating Shellshock

  • Shellshock is a psychological condition suffered by many of the men who fought in WW1
  • First it was defined by the soldiers proximity to bombardments and later it was broadened as the understanding of mental trauma increased. 
  • Ernest Jones said ''to indulge in behaviour of a kind that is throughout abhorrent to the civilised mind…. All sorts of previously forbidden and hidden impulses, cruel, sadistic, murderous and so on, are stirred to greater activity, and the old intrapsychical conflicts which, according to Freud, are the essential cause of all neurotic disorders, and which had been dealt with before by means of ‘repression’ of one side of the conflict are now reinforced, and the person is compelled to deal with them afresh under totally different circumstances''
  • Shellshock came to be a huge problem for the army - 80% of those suffering from it were unable to return to active service during the war.
  • Nervous conditions could be treated by massage, diet, electric shock treatments.
  • There was an onus on retaining the masculinity of the men, so facing up to the things that they had seen, done or heard were very much the order of the day. Talking treatment encouraged them to face his illness in a manly way.
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Gas Attack

  • Though prevention through the use of gas masks was attempted, many men suffered the affects of gas attacks.
  • Gases used in the war caused a number of medical issues.
  • Inhaled, they could choke a man by filling his lungs with the gas and in effect drowning him. Some of the gases used caused blistering. This could be internal as well as external.
  • Early response was to send the men for long periods of recovery at base camps or send them rest back in Britain.
  • From 1917 specialist teams were deployed close to the front line to tackle the effects of gas
  • Diagnosis and Treatment was -  Identify the patient as having been gassed, done by using a crayon to mark their forehead. Determine extent of the injury. This was difficult as sometimes the injury was psychological, men fearing they had suffered from gas. If actual, was it acute?
  • Treatments varied - 
  • Burns: the patient was washed and a sodium hypochlorite skin soaking applied. Burns from gases such as Mustard Gas could continue to blister for some time and were up to third degree burns.
  • Eyes: irrigation (water) was commonly used. For more acute cases atropine ointment could be used. This eased spasms of the eyelids and dilated the pupils artificially. Treatment could last several weeks.
  • Inhaled gas: the inhalation of gas could lead to blistering and ulcers. This made it difficult for patients to breathe. Treatment was rest and oxygen was used to ease breathing.
  • Mustard Gas: the US Army had mobile shower units that were designed specifically for hosing down men who may have come into contact with mustard gas.
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  • X rays were able to produce rudimentary imaging of broken bones etc. by the time of the first world war as they were invented in 1895.
  • The problem was that the machines were in large hospitals in Paris and the urgent medical need was at Base Hospitals near the front lines.
  • Curie devised a mobile X-Ray ambulance and 150 women were trained in the use of these ambulances - these were able to drive to base hospitals based on priority areas.
  • She then organised the construction of 200 X-Ray bases along the front lines at field hospitals 
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Hospital Ships

  • Number of wounded men during WW1 led to non medical buildings and ships being converted into makeshift hospitals. 
  • These incuded ships that held thousands of men and statley homes that opened up their rooms to nursing.
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Blood Tranfusions

  • Blood transfusion attempts were disastrous up until 1900 when Landsteiner identified different blood groups. This meant that it was now easier to transfer blood without it having the risk of contamination rejection and complication. 
  • In 1914 the process of transfusion was incredibley difficult as they faced the problem of clotting.
  • As war broke out it was discovered that sodium citrate could be used as an anticoagulant. This thinned the blood and reduced clogging risk - it wasnt especially reliable though.
  • in 1916 heparin was discovered by Maclean which was highly efficient and is still used today.
  • The use of heparin and effective blood transfusions on the western front took place after America entered the war.
  • Captain Oswald Robinson devised a system of blood banks and tansfusions - this collected and stored a large amount of blood of each type and as a result it was able to be used when and as it was needed.
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Battlefield Surgeons

  • Surgical Equipment available to surgeons was little different to that of a normal surgeon in a hospital.
  • The only difference is it needed to be mobile so would be selected to fit in cases.
  • It would include foceps, saws and drills. 
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Trench Foot

  • One of the main ailments
  • Men wore boots for a very long time and often the conditions were waterlogged. The two combone to create poor conditions for foot hygiene 
  • This meant that soldiers feet became so badly infected that toes would be amputated.
  • Treatment to keep their feet healthy would include antiseptic footpowders.
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