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Who first introduced aseptic surgery?
Joseph Lister used carbolic acid in 1865
How was surgery conducted after 1890?
They wore rubber gloves and gowns, washing faces and arms before surgery. Instruments were also sterilised in steam to prevent infection.
When was x-ray discovered?
1895 by Roentgen, a way to carry out diagnosis carefully before operations.
What were 3 problems with X-Rays?
Due to their primitive design, they released an unhealthy amount of radiation. They could also break easily and it took 90 minutes to take one x-ray.
Who did the first blood transfusion?
James Blundall in 1818 gave women transfusions when they had given birth but the blood could not be stored.
What were the 3 problems with blood transfusions?
Blood clots would happen, the body could reject incompatible blood. This rejection happened until 1901 when Landsteiner discovered blood groups and types. There was also a danger of infection if the equipment was unsterilised.
What are 2 features of a trench?
there would be a frontline trench where attacks would be made. A support trench would be 80 metres behind the front line, where troops could retreat if under attack. The trenches were zig zag in case of attack.
When was the first battle of Ypres?
1914, over 50,000 troops were lost but the British managed to keep Ypres.
What was Hill 60?
A man made hill that the Germans occupied in 1914, having an advantage. The British used offensive mining to take it back in 1915.
When was the second battle of Ypres?
1915
What happened for the first time at the 2nd battle of Ypres?
The Germans used chlorine gas for the first time at the 2nd battle of Ypres on 1915. 59,000 British troops died and the Germans moved dangerously closer to the salient.
When was the battle of the Somme?
1916
How many troops were lost in the first day in the battle of the Somme?
57,000 in one day
What 2 new tactics did the British use at the Somme?
Creeping barrage(Artillery would fire a "curtain" of shells in front of advancing soldiers.
The line of fire would "creep" forward, yard by yard, at a timed pace.
The goal was to destroy enemy defences and keep the enemy in their trenches until British troops were almost on top of them. and the first use of tanks. However the tanks had never been used before and had many technical issues.
How long were the tunnels in Arras?
They dug 2.5 miles of tunnels with a capacity of 25,000 men.
When was the battle of arras?
1917
Was the battle of arras successful?
Not really, they advanced 8 miles but over 160,000 soldiers were lost.
When was the 3rd battle of Ypres?
1917
What happened at the 3rd battle of Ypres?
The British were meant to break out of the salient, but it had rained for three days and it was incredibly muddy and waterlogged. 1/3 of shells had not gone off, so many died from the unexpected explosions. Men drowned in mud. There were over 245,000 casualties.
When was the battle of Cambrai?
1917
What was the problem with transport and communications?
The landscape had been destroyed by shells and was difficult to navigate for stretcher bearers. Horse drawn ambulances struggled with the amount of casualties so The Times raised enough money for over 512 ambulances.
What were 4 medical problems on the western front?
Trench foot, this was caused by the swelling of the feet from cold, mud and water. It caused gangrene, the decomposition or body tissue. It was prevented with whale oil rubbed into the feet and regular change of socks. If you got it, the only way to treat it was amputation. There was shell shock which caused headaches, nightmares and full mental breakdowns. It is said 80,000 men suffered it. There was hardly any treatment as they were seen as cowards and some were even executed. There was also wound infection because most of the land used to be farmer's fields, and so when the fertiliser got into wounds they became Severely infected. It would cause tetanus or gas gangrene. Injections against tetanus were used in 1914.
What year were caps swapped for Brodie helmets?
1915. It reduced head wounds by 80%
Were many killed by gas attacks?
Around 6,000 were killed. They were feared more than they did any harm.
What were the effects of chlorine gas?
Germans first used it in the 2nd battle of Ypres in 1915. Chlorine gas would suffocate you, so gas masks were given after 1915. Soldiers often had to make their own out of cotton pads soaked in urine. The British tried to use chlorine gas in the battle of Loos but it blew back.
What were the effects of phosgene?
It was used in 1915, similar to chlorine except it was faster acting. It could kill someone within two days.
When was mustard gas first used?
In 1917. It was odourless and worked within 12 hours. It would cause internal and external blisters, passing through clothes to burn the skin.
What was the RAMC?
Royal Army Medical Corps, responsible for medical care. They were founded in 1898.Stretcher bearers at the front
Regimental Aid Posts (RAP)
Field Ambulances and Dressing Stations
Casualty Clearing Stations (CCS)
Base Hospitals
✅ Responsible for:
Treating wounds and infections
Performing amputations and surgeries
Keeping medical records (e.g. wound and treatment cards)
Adapting to new injuries (e.g. gas attacks, trench foot, shrapnel wounds)
✅ Improved during WWI with:
Better training
More mobile medical units
Use of X-rays and blood transfusions at CCS
What was FANY?
First Aid Nursing Yeomanry. They were founded in 1907. They were the first women's voluntary organisation, providing frontline support.
Roles included:
Driving ambulances
Setting up mobile bath units, soup kitchens, and medical posts
Helping in dressing stations and field hospitals
Delivering supplies and messages across battlefield zones
✅ Important because:
First women to officially support front-line care
Helped ease pressure on the RAMC
Proved women could work in dangerous and vital war zones
What was the chain of evacuation?
RAP, dressing stations, casualty clearing station and then base hospitals
What did the RAP provide?
It was 200m from frontline, using in communication trenches. It was for immediate first aid but could not deal with serious injuries.
What did the dressing stations provide?
An advanced dressing station would be 400m from the RAP, and a main dressing station further back from that. They were in abandoned buildings where possible, but if not then in tents. There would be 10 medical officers and from 1915 more nurses too. They were also made up of the RAMC field ambulances. One unit could deal with around 150 casualties. In reality at Ypres, they had to deal with 1,000 casualties.
What was the casualty clearing station?
They were far away but close to transport. They were to deal with critical injuries and they split people in a triage.
What was the triage?
1 was the walking wounded, the ones who could be patched out and sent back to the front lines.
2 was the ones who needed hospital treatment, the ones who needed transporting to base hospitals after immediate wounds had been treated.
3 the ones with no chance of recovery. These men would be made comfortable but medical resources were given to those more likely to survive.
What are some statistics about CCS during the 3rd battle of Ypres 1917?
There were 24 CCS's in the Ypres salient. 379 doctors and 502 nurses treated over 200,000 casualties. 3.7% of admitted men, died.
What were the FANY'S main purpose?
From 1916, they drove the ambulances replacing the British Red Cross men. They worked at the Calais convoy and the st.omer's convoy.
What were they trained in?
Veterinary skills, first aid, signalling and driving.
Where were base hospitals?
On the French and Belgian coasts in order for there to be easier transfers of troops.
Did base hospitals do a lot of work?
Not really, in reality the CCS'S did more as contaminated wounds needed to be treated immediately. Instead base hospitals became responsible for testing out new medical techniques to be used in CCS. Methods such as diving patients into groups with doctors who were experts in the injury.
Why did Base Hospitals take back importante in 1918?
The Germans launched the spring offensive and the CCS'S had to move back. This meant base hospitals started doing surgeries again.
What were some features of the Arras underground hospital?
The tunnels were dug in 1916. There were waiting rooms, rest areas for the stretcher bearers, room for 700 stretchers, an operating theatre and a morgue.
What was wound excision/ debridment?
Cutting away the dead or injected flesh immediately, followed by stitching to close the wound. If the infected tissue was not removed, the infection would spread.
What was the Carral-Dakin method?
Antiseptics were useless for infections like gas gangrene. In 1917 the method of using salt solution in a tube was administered. It was effective but it only lasted 6 hours and couldn't be stored.
When was amputation used?
It was used frequently, but only as a last resort. By 1918, over 24,000 men had lost limbs. Queen Mary's hospital specialised in fitting artificial limbs, and by 1915 had fitted them for more than 26,000 men.
What was the Thomas Splint?
Men with shrapnel wounds only had a 20% survival rate, mostly due to the fact when they were being transferred the leg wasn't kept rigid and it became a compound fracture. The Thomas splint was designed by Hugh Thomas and his nephew introduced it to the western front. It increased the survival rate from 20% to 82%.
Who thought that x-rays would be helpful for seeing shrapnel on the western front?
Marie Curie. She equipped over 20 mobile x-ray vans, known as "little Curies".
What were the problems with the mobile x-ray units?
X rays didn't detect all objects, such as if clothing had stuck in a wound. The pictures took 90 minutes, which was a long time for an injured person to sit still. X-rays were fragile and overheated quickly, only to be used an hour at a time. This was bad due to the amount of wounded men.
Who used blood transfusions to stop shock?
Lawrence Robertson in 1917. He used the indirect method: using a syringe and tube to transfer blood.
What did Geoffrey Keynes design?
He designed a portable blood transfusion kit, and he also found a method to prevent clotting.special device in f;l ask to regulate blood flow
In 1915, how did Lewisohn make the indirect method of transfusing blood more safe?
He added sodium citrate to the blood.
In 1915, who found blood injected with sodium citrate could stay stored for 2 days?
Weil
What did Rous and Turner do to store blood for a month in 1916?
They added citrate glucose solution to the blood and found it could be stored for as long as a month.
Before the cambrai blood banks, who used similar methods?
Oswald Robertson used 22 units of blood to cure men on the front. He did this packed with ice in a box.
What percentage of all wounds were head injuries?
20%
Why would soldiers have next to no chances of survival of head injuries at the start of the war?
Infection also affected the head, men were confused or unconscious and so difficult or slow to transport and there were very few Doctors at the time who had experience with neurosurgery.
What did Cushing do?
He was an American neurosurgeon, who experimented with magnets to remove metal from the brain. He used local anaesthetic, which was numbing the operation site, instead of general anaesthetic, which was putting a patient to sleep, as it made the brain swell. Swelling increased the risks of the operation.
What were 3 observations made about head injuries?
Men who were treated more quickly were more likely to survive head wounds, this meant CCS'S became centres for brain surgery. Men were still vulnerable after treatment, and so they made sure the patients remained for at least 3 weeks after surgery. Thirdly, they observed that even if an injury looked minor, it may be serious. Consequently, All head wounds were examined carefully.
How many men did Cushing operate on in 1917?
He operated on 45 men with a survival rate of 71%.
Who was Harold Gillies?
He was an ears, nose and throat surgeon from New Zealand. He met Valadier, a dentist, during the war.
What did Gillies and Valadier do?
They saw the severe disfigurement some soldiers suffered, and became interested in facial reconstruction. Men were returned to Britain to undergo the surgery, as it could not be done in France. In Kent, Gillies designed Queen's Hospital which specialised in facial reconstruction. Almost 12,000 plastic surgeries were carried out by 1918.