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Sunday, April 7, 2013

First aid to American wounded soldiers, where, when, how

     A wounded soldier passed through many posts as he was removed from the front. Some of these travels took, sadly, days. Stories abound of men left on the ground in rain, snow and sleet as medical teams walked among them to analyze the severity of their injuries and determine how quickly and where they might be evacuated for treatment. Many men waited close behind the front lines, hearing the sound of the guns, bombs and airplane strikes that hurt them and their fellow soldiers even as they lay wounded. In fact, many doctors and nurses lamented that had they been able to treat their patients sooner, the men would have had a higher rate of survival and faster recovery. (In fact, improving the immediacy of treatment for a wounded soldier was the foremost goal of medical response teams throughout the war by all combatants and was implemented and improved on in each succeeding war.)

     When a soldier was wounded, he was assisted to the first aid station, dressing station or casualty clearing station by his pals or by stretcher bearers. (These first stops along the route backward from a front lines had many names and saw many variations, depending on numbers of medical teams, type of equipment and surgical and nursing specialists available. Triage was a function at each stage back of the line.) But before he got to such a station, the solider had in his possession a field dressing. (I have not yet found a U.S. field dressing picture. If anyone knows of one, I would heartily appreciate the url.)
    Here, courtesy of the British site, The Warwicks 1914-1918 (http://thewarwicks1418.com), I show you their First Field Dressing, FFD and their description:
Courtesy of and Copyright to  http://thewarwicks1418.com

"First Field Dressing (FFD) and Iodine ampoule carried on Active Service inside the lower right of the jacket."

Applied by the soldier himself or by those near him (if capable), this dressing consisted of iodine, the only easily packaged and affordable antiseptic/cleansing agent at the time. Penicillin was not yet used as a means to kill bacteria. Morphine was not readily available at the front lines, only backward of the line.
French church opened as ward used by Field Hospital #1, 2nd Division, June 16, 1918

   The next receiving station was a more intensive care unit. This post was a Mobile Hospital unit, literally moving by truck to one to four miles in back of an active front. This included a surgical team of doctors, nurses, and nurses assistants (what we would call orderlies) and/or stretcher bearers who were generally able-bodied types to carry wounded men. This mobile unit team, in the case of American facilities, assessed soldiers and divided them according to type of wound or disability. A team of doctors and nurses assessed each soldier and sent him either to surgery (in order of severity of wounds and operability), to a mental health receiving station or to a hospital treating only those with diseases. (These divisions were not rigorously applied because not all facilities were available in each sector. And at the end of the war, as fighting and casualties increased especially during the last Big Push from September 1918 through November 1918, dividing became nigh unto impossible.)
Nurse cleansing U.S. Marine's eyes of mustard gas during battle of Belleau Wood, June 1918

This mobile unit moved by truck, motorized or horse drawn, lived in tents and operated in tents. Their patients recuperated in tents, as well. Those who recovered to a stage where they could be transported farther back of the line were taken by ambulance. At this point, they went to a larger recuperative facility far back of the line in what the Americans called a Base Hospital.
Mobile Hospital #2, loaded and prepared for change of location. Carries sterilizers.

At the Base Hospital, the wounded were reassessed for fitness for duty. Some were returned to the front. Many received physical therapy by rehabilitation aides, or re-aids as they became known. Most were sent on down the line toward ports and ships home.
PHOTO, J. Power. Copyright of Illustration: 
Fort Sam Houston Medical Museum, San Antonio, TX