The Roses of No Man's Land
WENCHES IN TRENCHES
This was a mobile medical unit, not a vehicle. Each British division had three such units, as well as a specialist medical sanitary unit. The Field Ambulances as well as providing aid and relay bearer posts for the quick evacuation of the wounded, also established Main and Advanced (that is, forward) Dressing Stations where a casualty could receive further treatment and be got into a condition where he could be evacuated to a Casualty Clearing Station. Men who were ill or injured would also be sent to the Dressing Stations and in many cases returned to their unit after first aid or some primary care.
The Field Ambulance at full strength composed of 10 Officers and 224 men. The Bearer Division had 18 stretcher squads each of 6 men. The Tent Division was comprised of doctors: 9 medical officers and 1 dental officer, as well as 1 Quartermaster of stores, batmen, clerks, cooks, dispensers, nursing orderlies, and the Transport Division, which had 60 men attached from the Army Service Corps.
The Field Ambulances role was similar to modern day emergency ambulance services: to collect and transport patients to someone with specialized knowledge or to specialist equipment, whilst monitoring them, and treating them if necessary to ensure their condition remains stable. The personnel serving in the field ambulance achieved this by setting up various designated posts and sections according to distance from the RAPs to the Casualty Clearing Stations.
Image courtesy of NLS
Stretcher Bearers Relay Station Ginchy 1916
Image courtesy of IWM
Field Ambulance wagon passing over muddy ground near Ovillers, Somme, in September 1916
Image courtesy of IWM
Image courtesy of History Press
Image courtesy of National Library of Scotland
Image courtesy of Wellcome Collection
ADVANCE DRESSING STATION (ADS)
ADSs were set up as far forward as military conditions would permit. Ideally, this was about 400 yards behind the RAPs. Preferable locations were large houses, schools or churches but tents were used where necessary. In all events they needed to provide living accommodation for the officers and men; shelter from the weather; be inconspicuous and provide protection from the enemy, and had to be easily accessible with an entrance and an exit.
The personnel of each ADS were 3 officers and 53 ordinary ranks. Of these 1 officer was the Officer Commanding. 36 Privates would be employed as stretcher-bearers, with 1 officer supervising them. The others would be employed as clerks, dressers and cooks. If the ADS became overwhelmed with casualties the above personnel could increase.
Typical equipment for the ADS included stretchers, notice boards and flags for marking routes, empty petrol tins for water and kettles, hot water bottles, acetylene lamps, blankets, ground sheets, pyjama suits, stomach warmers, anti-tetanus serum, chloroform and No 1 Field Pannier, which included: wool, gauze, plain lint, shell dressings, 3 and 6 inch and triangular bandages, a jaconet and a calico, towels, nail brushes, safety pins, plasters, towels, tourniquets, a tincture of iodine, rum jars filled with eusol, and splints for leg and back as well as the Thomas splint.
The ADS was the first line of documentation for the RAMC, [i.e. Admission and Discharge books, war diaries etc]. Stretcher-bearers went forward and collected the sick and wounded from the RAP and carried them back to the ADS. A patient's medical condition was then assessed to make sure bandages had not loosened or become too tight, and also that the patient was not haemorrhaging or going into shock. Special attention was given to those marked with a "M" or "T" (morphine or tourniquet) at the RAP, and careful examination was given to see if the tourniquet needed to remain or not.
Surgery was not undertaken at an ADS unless absolutely necessary as it had no holding capacity. It was simply an intermediate stop to assess the patient. Those who were deemed to be urgent cases were transferred to the Main Dressing Station. Those who were not deemed as urgent cases were transferred straight to the Casualty Clearing Stations.
MAIN DRESSING STATIONS (MDS)
Ideally MDSs were sited roughly one-mile behind the ADSs. But in the Great War this was seldom the case, partly due to topography, but also because a MDS needed approximately 300 X 200 yards of space to provide sufficient room should it be taken over by a Casualty Clearing Station during an advance. The ideal location was a large building where water, light, heating and drainage were already supplied. If no buildings were available, then roughly 9 tents were used, with 1 reserved as an operating room.
MDSs needed to be located between the ADS and the Casualty Clearing Stations, closer to the latter if possible. They did not need protection from shell fire, but cover from the splinters of bombs had to be taken into account.
Structure: Every MDS was organised with six sections:
Receiving Section provided hot drinks, sandwiches, and cigarettes.
Recording Section where clerks took patient information and examined Field Medical cards
Resuscitation Section for warming and reviving those suffering from shock or the effects of haemorrhage.
Dressing Station where dressing were applied, and any urgent surgical treatment, administration of A.T.S. or morphia, if not carried out already.
Gas Section to keep gas victims away from other patients.
Evacuation Section where the patient's treatment was classified with whatever they were suffering from and how they were treated, and they awaited evacuation.
Other space was allocated for a mortuary, a cook-house, stores, and living accommodation for officers and others ranks.
Personnel: The personnel of each MDS included the Officer Commanding, 2 Medical Officers, a Dental Officer, a Quartermaster and 59 other RAMC ranks, along with 1 Royal Army Service Corps officer, and 44 other ranks ASC attached.
Equipment: Typical equipment at the MDS was very much the same as the ADS, with additions of oxygen apparatus, operating lamps collapsible trestles and a field dental outfit.
Duties: The MDS was further away from the firing line so was able to be better equipped to provide accommodation and treatment than an ADS. Urgent operations were more readily performed, and better arrangements could be provided for the resuscitation of those suffering from shock or haemorrhage, or both.
Read more in the next section: Casualty Clearing Station