the golden hour - u.s. army center of military historythe golden hour: american battlefield medicine...
TRANSCRIPT
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George Thompson
The University of Kansas Medical Center
The Golden Hour:American Battlefield Medicine in World War I
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Zone of the Armies
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Battlefield Medicine is:
• Care Under Fire
• Tactical Field Care
• Tactical Evacuation Care
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British Regimental Aid Station, Battle of the Somme, 1916
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Rifles fired out to 500 yardsMachine Guns fired out to 2 miles
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Light Artillery fired out to 11 milesHeavy Artillery fired out to 13 miles
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Railway guns fired out to 35 miles
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Zone of the Armies
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4,000 yards
11 to 13 miles
Zone of the Armies
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230,460 Admissions:
• 70,552 Gas Injuries
• 153,537 Battle Injuries
• 8,919 Cases of Neurasthenia
• 3,898 Shell-Shock Cases
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Battle injuries by destructive agents for American army troops, 1917-1918
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20 % to the head and upper trunk
25% to the upper extremities
20% to the trunk
35% to the lower extremities
Distribution of wounds on the body
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Battle injuries by admissions for American army troops, 1917-1918
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Dr. R. Adams Crowley, MD 1917 – 1991
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Zone of the Armies
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• Collect casualties from the battlefield and initiate first aid
• Control hemorrhage, shock and set fractures
• Give a prophylactic injection to prevent tetanus
• Initiate surgical procedures to prevent gas gangrene
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Time from injury to treatment:
1 hour: 10% mortality2 hours: 11% mortality3 hours: 12 % mortality4 hours: 33% mortality5 hours: 36% mortality6 hours: 41% mortality8 hours: 75% mortality10 hours: 75% mortality
P. Marquis Moulinier SantyDa Shock Tramatique dans les blessures de Guerre Analysis d'observations, 1918
Gas gangrene before an operation
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Members of the 137 Field Hospital tending casualties in a war battered church, 1918
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Zone of the Armies1st Level
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Zone of the Armies1st Level
2nd Level
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Company aid station, 1st Division, July 5, 1918
Company aid station, 4th Division, September 27, 1918
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Walking wounded in the Argonne Forest, 1918
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Battalion aid station, 79th Infantry Division in the Bois de Consenvoye
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Battalion aid station, 167th Infantry, July 17, 1918
Battalion aid station, 358th Infantry , October 27, 1918
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Battalion aid station, 28th Infantry , May 28, 1918
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• Control of hemorrhage
• Application or readjustment of field dressings and splints
• Injection of the anti-tetanus serum and morphine tablets for pain
• Treatment for gas injuries
• Anti-shock treatment such as warmth and hot drinks
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• Very slightly wounded but able to return to the line
• Slightly wounded and requires evacuation
• Seriously wounded
• Patient with fractures
• Severely wounded with attendant shock
• Gassed patient
• Psychoneurotic
• Sick
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• Painting around the wound with iodine
• Injection of 500 units of the anti-tetanus serum
• One-fourth grain of morphine for pain to slightly to seriously wounded
• Control of hemorrhage through ligature, hemostats or a tourniquet
• Immobilization of fractures with splints
• Shock treatment such as blankets, hot water bottles, hot drinks
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Collecting point for wounded, 3rd Division, October 12, 1918
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Field Hospital No. 13
Dressing station, Ambulance Company No. 102
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Advance post, Ambulance Company, 1st Division , Missy-aux-Bois, July 20, 1918
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Dressing station, Ambulance Company No. 111
Dressing station first aid kit
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• Arresting hemorrhage
• Inspecting and readjusting the dressings and splints
• Administering morphine and the anti-tetanus serum
• Treating for shock and gas injuries
Dressing station, Lahayville, France, 1918
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Dressing Station near Avocourt, France, September 26, 1918
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Dressing station, Ambulance Company No. 102, near Samogneux, France, October 23, 1918
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Triage, 42nd infantry Division, near Suippes, France, July 17, 1918
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Field Hospital No. 28, Varennes, October 2, 1918
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Field Hospitals No. 314 and No. 315, 79th Division, France 1918
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• Wounded and gassed
• Sick
• Skin and venereal diseases
Field Hospital No. 13, near Vendeull-Caply, France, July 2, 1918
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Church at Benzu-leGuery, Field Hospital No. 1, 2nd Division, June 16, 1918
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Triage, 77th Division, La Chalade, September 28, 1918
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Slightly wounded awaiting readjustment of dressings, Field Hospital No. 28, October 2, 1918
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Administering a hot drink to a shock patient
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Mustard gas casualties being bathed with soap and water
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Evacuating wounded from Field Hospital No. 15, near Montruil, France, June 7, 1918
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Zone of the Armies1st Level
2nd Level
Base Hospitals
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Zone of the Armies
2nd Level
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Mobile Hospital No. 2
Reception Room, Mobile Hospital No. 39
Mobile Hospital No. 30
Operating Room, Mobile Hospital No. 39
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Evacuation Hospital No. 1
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Surgery in progress in an operating theatre, No. 3 Casualty Clearing Station, July 1916
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Patients arriving at the Receving Room, Evacuation Hospital No. 8
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Ground plan for Evacuation Hospitals 6 and 7 located at Souilly, France, 1918
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Receving Room, Evacuation Hospital No. 8 Sorting patients at the Receiving Room
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10 operating, 4 x-ray rooms, 16 hospital wards performed the surgical work
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Heating chamber for shock patients
Fractured clavicle, lodged missile in the end of the clavicle
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Operating room and sugical team of Evauation Hospital No. 8, 1918
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Debridement: Excision of the external wound, of the aponeurotic layer, of injured muscles
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The Carrel-Dakin method, Duchess of Sutherland Hospital, Calais, 1917
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Page from the operating room record kept by Dr. Frederick A. Pottle, MD, Medical CorpsEvacuation Hospital No. 8, Petit Maujouy, France, 1918
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Post-operative ward of an Evacuation Hospital
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Loading patients on to a Hospital Train
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Zone of the Armies
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Battalion aid station, 79th Infantry Field Hospital No. 28
Point of Injury Evacuation Hospital No. 8
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Dressing Station near Avocourt, France, September 26, 1918
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Dressing station, Lahayville, France, 1918
Forward Surgical Team
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Evacuation Hospital, France Combat Support Hospital, Iraq
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The most enduring legacy that informs the army today is a “medic-to-surgeon” mentality
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American Wounded Making Way to First Aid Station in the Village of Marne During German Attack by George Mathews Harding