RAMC & FANY: The Stages of Treatment (Edexcel GCSE History)

The Chain of Evacuation in WWI - Summary

The stages of treatment and chain of evacuation on the Western Front

Regimental Aid Post

• The Regimental Aid Post (RAP) was around 200 metres from the frontline

• Located in communication trenches or deserted buildings

• Wounded soldiers arrived by walking or from stretchers

• Staffed by a Regimental Medical Officer and stretcher-bearers with first-aid knowledge

• The purpose was to give immediate first aid:

  • Soldiers with more serious injuries were transported to Dressing Stations

Field Ambulance & Dressing Station

Field Ambulance

• A mobile medical unit of the RAMC which treated around 150 wounded soldiers at a time:

  • It was a group of RAMC medical staff, not a vehicle

  • The Field Ambulance at Hooge in the Ypres Salient helped 1,000 soldiers from 10-11 August 1917

• They were also responsible for establishing Dressing Stations

Dressing Stations (ADS and MDS)

• There were two types of Dressing Station:

  • The Advanced Dressing Station (ADS) was around 400 metres behind the RAP

  • The Main Dressing Station (MDS) was around a mile behind the RAP

• Located in dug-outs or abandoned buildings to stay protected from artillery

• Wounded soldiers arrived by walking or on stretchers

• Staffed by ten medical officers, along with stretcher-bearers from the RAMC. From 1915 there were also nurses 

• The purpose was to give emergency first aid to the wounded:

  • Those who required further treatment were transported to Casualty Clearing Stations (CCS)

Casualty Clearing Station

• The Casualty Clearing Station (CCS) was a few miles from the frontline

• They were located in permanent structures like factories or schools, close to a railway line. This allowed rapid transport of the seriously wounded

• Wounded soldiers arrived by ambulance

• Staffed by doctors and nurses who treated life-threatening injuries like limb amputations

• The purpose was to divide the wounded using a system called triage:

  • Walking wounded returned to the fighting after minor treatment

  • Those who needed hospital treatment were sent to base hospitals

  • Those who were so severely wounded that they were not going to survive. These soldiers were made as comfortable as possible until they died

• The CCSs during the Third Battle of Ypres in 1917 were responsible for treating many wounded:

  • 24 CCSs in total

  • 379 doctors and 502 nurses

  • 200,000 casualties treated

  • Only 3.7% of casualties died

Base Hospital

• Base Hospitals were near the French and Belgian coasts

• The Base Hospital: 

  • Was usually a civilian hospital or large building

  • Wounded soldiers arrived by train or canal barge (which was more comfortable for travel)

  • Was staffed by many medical staff including doctors and nurses

• Reliance on Base Hospitals increased towards the end of the war when the German Army launched the Spring Offensive, meaning CCSs were more vulnerable to attack

• The purpose was to give specialised treatment to wounded soldiers:

  • Most base hospitals had operating theatres, x-ray departments, and treatment areas for gas poisoning 

  • Casualty Clearing Stations then used the techniques perfected in Base Hospitals 

• Hospital ships transported soldiers back to Britain for further treatment 

The Underground Hospital at Arras

• The Battle of Arras 1917 was a major event during the First World War

• The ground around the town of Arras is very chalky and suitable for digging:

  • In 1916, Tunnelling Companies from Britain and New Zealand linked together 2.5 miles of tunnels in five months

  • The tunnels were home to 25,000 men by 1917

• Within the 800 metres of tunnels there was a fully functioning underground hospital:

  • Nicknamed Thompson’s Cave - Thompson was the name of the RAMC officer who equipped the hospital

  • There were 700 spaces for stretchers or waiting areas

  • Electricity and piped water were available

  • In 1917 an artillery shell destroyed the water supply and the hospital was no longer used