Civil War Medicine: A disaster and lessons learned
The practice of pharmacy & medicine plagued by unsanitary conditions, lack of medical advancements & knowledge, crowded camps, and most importantly: effective medicine. Note that this was a time where physicians still advocated for bloodletting, purging, and humor rebalancing.
- Once a soldier was wounded, medical personnel on the battlefield bandaged the soldier as fast they could, and gave him whiskey (to ease the shock) and morphine, if necessary, for pain.
- Opium gum, laudanum or morphine to treat the pain of gunshot wounds and other injuries, as well as diarrhea and cough.
Several key figures played a role in the progression of medicine at this time. Jonathan Letterman, the Medical Director of the Army of the Potomac, brought “order and efficiency in to the Medical Service” with a regulated ambulance system and evacuation plans for the wounded. As surgeon general of the Union army, William A. Hammond standardized, organized and designed new hospital layouts and inspection systems and literally wrote the book on hygiene for the army.
A surgeon performing a leg amputation during WWII (1944).
German Combat Medic provides aid to a soldier suffering from a leg wound during WWII (1940).
Syrette of morphine: 10mg auto-injector. A syrette is a device for injecting liquid through a needle, almost similar to a syringe, except that it has a closed flexible tube, instead of a rigid tube and piston. This was a mainstay of forward combat casualty care.
American Army doctor performing surgery in an underground bunker located in Bougainville, Papua New Guinea (WWII, 1943). The patient suffered a gunshot wound from a Japanese sniper.
Royal Army Medical Corps physician attends to a wounded soldier (WWII, 1944).
Captain Clarence Brott applies cast to a soldier who's thigh was hit with a shell fragment (WWII, 1943).
Battlefield medicine improved throughout the course of the war.
- At the beginning, only plasma was available as a substitute for the loss of blood. By 1945, serum albumin had been developed, which is whole blood that is rich in the red blood cells that carry oxygen and is considerably more effective than plasma alone.
- To treat bacterial infections, penicillin or streptomycin were administered for the first time in large-scale combat.
- Service members with combat fatigue, which later became known as post-traumatic stress disorder, were given a safe place to stay away from battle zones with plenty of food and rest. This resulted in about 90% of patients recovering enough to return to the fight.
- Service members were also inoculated with vaccinations for smallpox, typhoid, tetanus, cholera, typhus, yellow fever and bubonic plague, depending where they were sent.
Because of improvements like these and others, the survival rate for the wounded and ill climbed to 50% during World War II from only 4% during World War I, according to Dr. Daniel P. Murphy, who published a paper on "Battlefield Injuries and Medicine."
UNIT ONE PACK (Part 1 - Fluid Resusication & hemorrhage control)
- IV Fluids and Tubing (NS 0.9%)
- Lactated Ringers Solution
- Hetastarch or Hextend
- 18, 16, and 14 Guage IV catheters
- IO access kit (FAST 1, EZ IO Drill)
- Tourniquets
- Emergency trauma bandages, gauze, and hemostatic agents (i.e. Celox quick clot bandages)
UNIT ONE PACK (Part 2 - Airway Management, Diagnostic Equipment )
- Asherman chest seal, Bolin chest seal, Hyfin chest seal
- Nasopharyngeal airway tubing ***
- Oropharyngeal airway device
- King LTD tubing
- Cricothyrotomy kit (scalpel, NPA)
- Stethoscope, blood pressure cuff, pulse oximeter, otoscope, opthalmoscope, thermometer
Resources
- Middleton, Thomas (2010). Saber's Edge: A Combat Medic in Ramadi, Iraq. UPNE. p. 7.
- Rottman, Gordon (2016). World War II US Army Combat Equipments. Oxford: Osprey Publishing. p. 54. ISBN 9781472814241.
- Steve Elliott. "All military medical training roads now start at METC". Aetc.af.mil. Archived from the original on 2013-11-03. Retrieved 2020-09-12.
- Author Unknown. "Antibiotics in the Tactical EMS Environment." 9 September, 2009
- Dixon, I. (2019, July 24). Civil War Medicine. Retrieved December 11, 2020, from https://www.battlefields.org/learn/articles/civil-war-medicine
- Pasquier, Pierre et al. “The French Syrette of morphine for administration to combat casualties.” British journal of pain vol. 10,2 (2016): 66. doi:10.1177/2049463715622958
- Journal of Special Operations Medicine - Fall 2008 Training Supplement
- PHOTOS: https://allthatsinteresting.com/combat-medics-historical-photos
- PHOTOS: Google Images
- PHOTOS: Library of Congress, online media