New Zealand Medical Services in Middle East and Italy
Treatment of the Wounded
Treatment of the Wounded
Treatment carried out by the RMOs consisted in the application of field dressings and the preliminary splintage of the limb as required. Injections of ATS in doses of 3000 units were given, and of morphine up to half a grain.
Wound treatment in the field ambulances varied according to the circumstances at the time. At the beginning of hostilities a certain amount of surgery was carried out at the MDS, especially that to which the surgical team was attached. When the withdrawal began the medical units were leapfrogged back as the combatant troops passed by them. Little but the most urgent treatment was attempted and the cases were evacuated for definitive surgery to 2/3 Australian CCS at Elasson and later, when that unit went back south of Lamia on 14 April, to 24 CCS near Larisa. This unit, with the section of 189 Field Ambulance, remained active until all casualties had been dealt with and the army—with the exception of a rear party—had retired behind them. When 24 CCS also retired south of Lamia on 18 April, treatment was carried out either in the vehicles of the ambulances as they withdrew or at car posts temporarily set up at intervals along the lines of evacuation. It was not until stability was reached behind the Thermopylae line that an operating centre was set up by 5 Field Ambulance at Kamena Voula in a Greek hospital, and a little major surgery—including an operation for a perforating abdominal wound—was able to be carried out.
The principles of treatment adopted were the excision of the wound, the prevention of bleeding, and the provision of drainage. Dressings consisted of the field dressing, and vaseline gauze had also been supplied both to the hospitals and the field ambulances. Acriflavine was used as a local antiseptic, and in some cases sulphonamide was administered by mouth to the seriously wounded men. Thomas splints, with metal traction clips fixed to the heel of the boot, were used for fractures of the lower limbs. Kramer wire and plaster-of-paris were also used for fracture cases, mainly at the CCS. The wounded admitted to 1 NZ General Hospital at the beginning of hostilities, who had been operated on either at the field ambulances or at the CCS, were found to be in excellent condition, and did not require redressing before being sent on by ambulance train to 26 General Hospital in Athens.page 136
The experience in the treatment of war wounds was a new one to the staffs of the ambulances, and the New Zealand medical services were strengthened by having a surgeon of considerable general and orthopaedic experience attached to a field ambulance as a member of the surgical team. The quality of the work varied very much, as was only natural, since much of the urgent and imperative surgical treatment of wounds was carried out by young medical officers with no previous experience of the treatment of war wounds, but under the circumstances the work was well and most conscientiously done.
Special blood-transfusion panniers had been procured in Egypt for each of the field ambulances, but the rapidity of the withdrawal, and the consequent lack of stability in medical units, made it impossible to use blood transfusions for the wounded men, and dry plasma only was available, in small quantities, in one of the field ambulances. Fifth Field Ambulance was supplied with six bottles of plasma prior to the action in Greece and also picked up a considerable stock of plasma and glucose saline from the site of 1 NZ General Hospital during the withdrawal. Blood-transfusion facilities were available, but not used, at our general hospital at Pharsala. Intravenous fluid was given occasionally and a few Baxter Vacolites were available at the MDSs of the field ambulances. Morphia was used freely and doses of ½ gr. were given to seriously wounded men. Some of the medical officers in the ADSs were in the habit of administering pentothal to very severely wounded men in addition to ½ gr. doses of morphia. A solution of 5 cc. was made up and 2 cc. injected into the vein and 3 cc. into the buttock. The patient then usually slept right through to the MDS and thereby had a better chance of recovery.
Gas gangrene was comparatively rare. There were several cases of gas in the tissues, generally associated with localised gangrene of muscle or muscle groups, which responded well to free excision of the involved muscle. Serum was administered.