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1

who were experiments in blood transfusions performed by?

James Blundell in 1819

2

how were transfusion's carried out?

with the donor being directly connected by a tube to the recipient

3

what were the problems with the early uses of blood transfusions?

blood clots as soon as it leaves the body and so the tube became blocked up
the blood of the donor was sometimes rejected by the recipient because they were not compatible
there was a danger of infection from unsterilized equipment

4

when were blood groups discovered?

Karl Landsteiner in 1901

5

how was the problem of infection solved?

by aseptic surgery which was invented by Joseph Lister in the 1860's through the use of carbolic acid after hearing about the germ theory in 1865
the use of antiseptics immediately reduced death rates from as high as 50% in 1864-66 to around 15% in 1867-70

6

how were blood transfusions used in WW1

used at base hospitals from 1915
a syringe and tube used
extended to casualty clearing stations from 1917
a portable blood transfusions kit was close to the front line invented by a doctor called Geoffrey Keynes

7

how did the discovery of sodium citrate benefit blood transfusions?

it prevented blood clotting so that blood could be stored outside of the body in 1915

8

regarding blood transfusions what was discovered in 1916

it was discovered that adding a citrate glucose to blood allowed it to be stored for up to four weeks

9

what was used in the battle of Cambrai in 1917

blood was stored in glass bottles at a blood bank and used to treat badly wounded soldiers throughout the battle

10

what was stage one of the chain of evacuation

stretcher bearers
advance on no mans land at night or during a break in fighting to collect the dead and wounded. Each battalion had 16 stretcher bearers and it took 4 men to carry a stretcher

11

what was stage 2 of the chain of evacuation

Regimental Aid Post - RAP
always close to the front line and the battalion regimental medical officer was in the RAP. He identified those who were lightly wounded and those soldiers who needed more medical attention

12

what was stage 3 of the chain of evacuation

field ambulance and dressing station
a field ambulance was a large mobile medical unit with medical officers, support and staff and from 1915 some nurses.
The dressing stations was where medical emergency treatment was given to the wounded and they were about a mile behind the front line and here a system of triage was set up where the men where separated depending on injury

13

what was stage four of the chain of evacuation

the casualty clearing station - CCS
the first large and well equipped medical unit that the wounded would experience. The CCS contained x ray machines and wards with beds and they were located in tents or huts about 10 miles from the conflict

14

what was stage 5 of the chain of evacuation

the base hospital was usually a civilian hospital or converted building and soldiers would arrive by train, ambulance, canal because the journey was more comfortable and they had operating theatres x-ray departments and areas for gas poisoning. From the base hospital most patients were sent back to Britain in hospital train which has being converted.

15

what was there in regards to help of the wounded in war by November 1915

there was 250 motor ambulances in France and ambulance trains were also introduced to carry up to 800 casualties. Ambulance barges were also used to carry the wounded along the river Somme.

16

discuss the underground hospital at Arras?

During the battle of Arras during April-May 1917 160,000 soldiers were killed and over 7000 were injured in the first three days despite this the evacuation route worked and in 1916 the existing tunnels and quarries were extended. They created an underground town for soldiers to live in with running water and electricity and a hospital with 700 beds and operating theatres

17

discuss the RAMC

Royal Army Medical Corps
all medical officers belonged to the RAMC the membership increased from 9000 in 1914 to 113,000 in 1918 as the number of wounded grew. |Doctors had to learn quickly about conditions and wounds they has never faced before.

18

discuss the FANY

First Aid Nursing Yeomanry founded in 1907 by a soldier who hoped they would be the nursing cavalry to help the wounded in battle
Initially the nurses on the front line were the well-trained Queen Alexandra's nurses and the government turned away volunteer nurses. However this attitude changed as the number of wounded increased
volunteers worked as professional theatre nurses to floor scrubbers
they helped as ambulance drivers and nurses once the British army changed their policy towards volunteers in 1916
they also carried supplies to the front line and drove motorised kitchens to supply food

19

what was triage

a system of splitting the wounded into groups according to who needed the most urgent attention

20

what was set up in 1123

St Bartholomew's Hospital in London and at first it specialised in the treatment of poor, pregnant women

21

what was set up in 1247

St Mary's of Bethlehem was established and specialised in the treatment of "poor and silly" people

22

what did many towns have

leper houses outside their walls their walls or "hospitality" places for travellers

23

what were almshouses in the medieval period

small hospitals set up to provide a home for the old and those unable to work who might otherwise have had to live on the streets and beg for a living

24

what was the routine of care in a hospital in the medieval period

you rang the doorbell in medieval hospitals
went to a chapel
the bath - the nuns or sisters took your clothes and boiled them then baked them in an oven
you then went into clean sheets overnight

very few hospitals employed either physicians or surgeons
most care carried out by nuns and elderly women
the main treatment was prayers
most monks and nuns had an excellent knowledge of herbal remedies

25

what was the problem in 1914

there were no motor ambulances and the horse-drawn carriages were unable to cope with the large number of casualties

26

how did attitudes in the 18th century change

there became more hospitals as funding increase because in 1700 there were only 5

27

what were hospitals like by the 1900 in the industrial period

different wards split up infections from surgery needing
operating theatres
specialist departments with new equipment and space for certain procedures
cleanliness now important - clean up germs using antiseptics and by 1900 focused on preventing germs
doctors common
trained nurses lived nearby
new ideas adopted quickly
everyone competing for most modern with best doctors and donations
now a place where the sick were treated

change in role had forced a change in the way hospitals were built and run

28

the first public health act

1848
cities were encouraged to set up Boards of Health and provide clean water supplies. However it was not compulsory so many cities didn't do it

29

the second public health act

1875
cities now forced to improve sanitary conditions by:
- providing clean water to stop spread of disease
- disposing of sewage to avoid pollution
- building public toilets
- employing a public officer of health to monitor conditions and outbreaks of disease
- creating street lighting

30

mass vaccinations

the government introduced compulsory vaccinations throughout the 20th century including diphtheria in 1942 and polio in 1950
these vaccination campaigns were funded by the government to ensure that they were widespread