WW1 Medicine + Life on the Western Front

• What was the trench system?

  Trenches were dug in zigzag shapes to prevent enemies firing directly down a trench. They were also very narrow.

  
• What is the frontline trench?


  The frontline trench was closest to No-mans land and enemy trenches. This is where they attacked from.

  
• What was the support trench?

  This was 80m behind the frontline.

  Troops retreated here if the front line was overrun.

  
• What was the communications trench?


  This ran between the other trenches.
• What was the reserve trench?

  A trench 100m behind a support trench where reserve troops could be mobilised(get ready) for a counter attack if needed
• What was Ypres(Belgium) like?

  1st battle 1914- British lose 50,000

  2nd battle 1915- First use of chlorine gas by the Germans

  3rd battle 1917- Germans on high ground(advantage)- British on lower ground so they had waterlogged trenches and could risk drowning or trench foot.

  Hill 60 - man made hill-German captured in 1914-UK used mines to clear it-the UK tunnelled under and placed mines to blow up

  
• What happened in the Battle of the Somme (1916)?

  57,000 British casualties and 20,000 British deaths on day 1

  400,000 casualties by the end.

  First use of tanks, but it was unsuccessful

  
• What was the Battle of Arras like (1916-17)?

  Chalky terrain-easy tunnelling

  Underground hospitals and bases- electricity, running water and operating theatres

  
• What happened at the Battle of Cambrai (1917)?

  First successful large scale use of tanks, which were effective at crossing trenches

  First blood depot/bank set up to store blood- soldiers can now transfuse blood without another soldier to be present to give it.

  
• What illnesses were there?

  Trench foot

  Trench fever/pyrexia

  Shellshock
• What is trench foot?

  Cold, muddy conditions caused less blood flow which caused the cells on the feet to die and become gangrenous.

  To prevent this, water was pumped out of trenches, socks were changed regularly and whale oil was rubbed on feet

  Amputation was required in severe cases

  
• What is trench fever/pyrexia?

  Lice caused this.

  Flu like symptoms-body ache, fever, headache

  recurring symptoms if not treated

  12 weeks away from trench in base hospital needed

  delousing stations set up to burn lice eggs in clothes
• What is shellshock?


  Mental illness due to constant fear in the trenches

  tiredness, shaking, nightmares, loss of speech

  80,000 troops affected

  not properly understood at the time-thought to be cowardice
• What wounds were there?

  Gas gangrene

  Shrapnel and ammunition

  Head injuries
• What is gas gangrene?

  Bacteria from shrapnel and shells entered wounds and caused infections. This could kill within a day.
• What is shrapnel and what did it do?

  Shrapnel is fragments of shells.

  60% of shrapnel injuries were to the arms and legs

  At the start of WW1 there was a 20% survival rate of shrapnel wounds to the legs

  Machine guns could fire 500 rounds per minute and fracture bones

  
• How were head injuries prevented?

  A brodie helmet was introduced in 1915 made of steel

  It reduced fatal head wounds by 80%

  
• What gas attacks were there?

  Chlorine gas, first used by Germans in Ypres in 1915 - suffocation, temporary blindness, asphyxiation

  Phosphene gas, used near Ypres end of 1915- faster acting than chlorine gas

  Mustard gas, first used by Germans in 1917- odourless, similar symptoms, also caused blistering inside the body (lungs) and outside on the skin
• How did soldiers prevent damage from gas attacks?

  They urinated onto cotton pads and covered their faces

  Gas masks were introduced in July 1915

  
• How were wounded soldiers transported out of the trenches?

  Stretcher bearers carried them away

  they carried basic medicine-morphine to relieve pain and bandages

  16 stretcher bearers per 1000 men in a battalion

  could take 8 men per stretcher

  
• What was the chain of evacuation?

  Regimental Aid post -> Dressing Stations -> Casualty Clearing Stations -> Base Hospitals
• What was the regimental aid post?

  200m from the front line, in communication trench or deserted buildings

  Medical officer with basic first aid knowledge

  Immediate first aid provided-morphine/bandages

  
• What was a dressing station?


  med staff, nurses, support

  set up dressing stations in tents or buildings

  triage system(splitting people into groups based who needed more assistance)

  400m to 1/2 mile behind the RAP

  severe cases sent to casualty clearing station by ambulances

  
• What ambulances were used in WW1?

  Horse drawn carriage-couldn't cope with large amounts-men in these were shaken, causing further injury

  1914 - ambulance wagons used to make it safer

  First motor ambulance 1914 by Red Cross-couldn't operate well in muddy terrain
• What is a casualty clearing station?

  7 to 12 miles away from front lines

  large, well equipped

  had operating theatres, mobile X-ray machines-beds for 50 men-deal with 1000 casualties at a time​

  triage system-walking wounded, those in need of treatment and those with no chance of recovery

  sent wounded to base hospitals

  
• How did people get to base hospitals

  Train or canal

  Some trains had operating theatres

  Ambulance trains could carry 800 at a time​
• What was a base hospital?

  Last part of the chain of evacuation

  built near railways for quick transport

  Near French or Belgian coast to ship soldiers back home if needed

  more serious wounds (amputations, head injuries, chest wounds) treated

  
• Who treated patients?


  1914 all med officers are part of the RAMC - Royal Army Medical Corps - many jobs(e.g ambulance driver, stretcher bearer, doctors etc)​

  Military nurses-Queen Alexandra's nurses-10,000 of them-many jobs(professional nurse, cleaning, cooking, washing clothes)​

  First Aid Nursing Yeomanry (FANY)-500 women-mainly ambulance drivers
• What new developments were there in medicine?

  Thomas Splint

  Mobile X ray units

  Blood transfusions

  Carrel-Dakin method
• What was the Thomas splint (1915)?


  A structure to hold a leg to stop the joints from moving

  This prevented further injury and blood loss

  survival rate went from 20-82% for leg wounds

  
• What were mobile x-ray units?

  X-rays were used to identify shell fragments, shrapnel and bullets in wounds

  6 mobile x-ray machines were developed

  Machine linked to engine of van and set up on a table

  Easier identification and removal of shrapnel/bullets to prevent infection
• What were blood transfusions?

  When a soldier's wound bled they lost blood, which they needed to regain

  Karl Landsteiner discovered different blood types in 1900

  First transfusions used from 1915 from one person to another using syringes

  Adding sodium citrate prevented blood clotting, allowing it to be stored so another person wasn't needed

  First blood bank set up at Cambrai in 1917

  22 bottles stored

  citrate glucose allowed longer storage of blood (up to 4 weeks)

  
• What was the Carrel-Dakin method(1917)?


  A system of tubes that flowed sterilised salt solution through wounds to kill bacteria and prevent infections and gas gangrene

  solution lasted 6 hours so it had to be made when needed.

  
• What head treatments were there?

  Brain surgery

  Plastic surgery
• What was brain surgery?

  Head injuries were usually fatal due to infection, difficulty moving them and lack of neurosurgery experience in doctors

  Harvey Cushing, an American neurosurgeon developed new techniques such as using magnets to remove metal fragments and using local anaesthesia to keep them awake when operating to stop the brain swelling.

  
• What was plastic surgery?

  Head injuries that weren't fatal also caused disfigurement

  New Zealand doctor Harold Gilles developed facial reconstruction to replace and restore destroyed parts of the face.

  Plastic surgery had to be done in Britain from 1917 in Queen's hospital, Sidcup, Kent

  12000 operations had been carried out by the end of the war

  
• First Battle of Ypres

  1914

  • British lost 50000 troops
  • British maintained control over Ypres
• Second battle of Ypres

  April 1915

  • First time Germans used Chlorine gas on the Western Front
  • British losses : 59,000 men
• The Battle of The Somme

  1916

  • Large casualties on both sides
  • approx 20,000 men killed (British)
  • Injuries approx 400,000
  • British tried new strategies : Creeping Barrage & Tanks in warfare.
  • Tanks not successful - would get stuck in mud & craters from shells
• Battle of Arras

  1917

  • 24,000 British men attacked in attempt to break through German lines
  • built tunnels to create shelter
  • provided safe underground movement