_The Chain of Evacuation
The Chain of Evacuation
The process of removing a wounded soldier from the battlefield back to a hospital in Britain required an incredible amount of manpower and coordination. Retrieving a casualty from No Man's Land could be suicidal at the best of times. Each stage along the way had its function and capabilities. The RAMC had many officer doctors and together with experienced first aid trained other ranks, life saving treatment could be adminsistered at any stage. The process was not finite. Stages may be leap-frogged or urgent cases may be passed through with haste. Often the casualty wouldn't have been aware he had been carried, lifted and bundled across 15 miles or so of rough ground.
The first stop for a wounded soldier would be the Regimental Aid Posts (RAP), this was often based within the front line trench and manned by the Battalion Medical Officer and his orderlies. He was either treated and returned to the fighting or directed for treatment via a Bearer Relay Posts or Walking Wounded Collecting Posts (WWCPs) that could be some 600 yards behind the front line. Regimental bandsmen and some FA stretcher bearers were used to remove the injured.
The process of removing a wounded soldier from the battlefield back to a hospital in Britain required an incredible amount of manpower and coordination. Retrieving a casualty from No Man's Land could be suicidal at the best of times. Each stage along the way had its function and capabilities. The RAMC had many officer doctors and together with experienced first aid trained other ranks, life saving treatment could be adminsistered at any stage. The process was not finite. Stages may be leap-frogged or urgent cases may be passed through with haste. Often the casualty wouldn't have been aware he had been carried, lifted and bundled across 15 miles or so of rough ground.
The first stop for a wounded soldier would be the Regimental Aid Posts (RAP), this was often based within the front line trench and manned by the Battalion Medical Officer and his orderlies. He was either treated and returned to the fighting or directed for treatment via a Bearer Relay Posts or Walking Wounded Collecting Posts (WWCPs) that could be some 600 yards behind the front line. Regimental bandsmen and some FA stretcher bearers were used to remove the injured.
Next down the line came the Advanced Dressing Station (ADS), one per Bagade. This could be a section of a trench or a sheltered outbuilding. Here they would be assessed and moved down the line as quickly as possible.
An Advanced Dressing Station might have been in a trench or a field
Depending on the state of the battle, the type of wounded and the distance and terraine between the ADS and the Main Dressing Station (MDS) several methods of carriage were adopted.
Walking wounded. With assistance or as part of a convey of wounded.
Wheeled Stretchers. Ideal for longer distances on trackes or roads.
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Carried by Stretcher bearers. Stretcher squads consisted of 6 bearers.
Horse drawn or motorised transport. Light railways were often laid from the battle fields with small hand pushed or horse drawn carriages.
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Main Dressing Station (MDS) may have been some miles behind the line and likely to be the FA's HQ. They were not always out of reach from heavy bombardment and might have to move back if they came under attack. All this did was delayed the removal of the wounded and added to the work of the Field Ambulances.
_Collecting Posts (CPs) and Relay Posts (RPs) along the evacuation chain assisted the relay of the wounded. Teams would take sections of the route, passing the wounded from team to team. Set routes were arranged in advance to avoid bottle necks. This allowed the movement of the wounded not to hinder the advancing units going up the line.
_Collecting Posts (CPs) and Relay Posts (RPs) along the evacuation chain assisted the relay of the wounded. Teams would take sections of the route, passing the wounded from team to team. Set routes were arranged in advance to avoid bottle necks. This allowed the movement of the wounded not to hinder the advancing units going up the line.
Oneway systems helped transport the wounded away from the front line
_Casualty Clearing Station by Henry Tonks Aug. 1918
_Casualty
Clearing Station near Vaux, August 1916.
A train back to a base hospital or even Blighty
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A Casualty Clearing Station (CCS) would have been set up some 12 miles behind the front line and could hold between 200 and 1000 wounded for up to a week. During heavy fighting a CCS could be overwhelmed with greater numbers. Here they had time to be fully assessed and either returned to their units once patched up and rested or passed back to a base hospital. This was the first stage along the evacuation chain where major operations could be undertaken. It is a sad fact that many CCS locations are now marked by the presence of the larger Commonwealth War Grave sites. A key factor to the position of a CCS was transport. Most were based within easy reach of railways or canals. They also needed to be mobile. Battle conditions could change and so did the CCS position, either forwards or backwards. The holding time for 'non Blighty' wounds was about four weeks. This allowed some to return to their units after treatment. If wounds needed longer to heal the patient would be shipped down the line to a Stationary Hospital, General Hospital or Base Area. A Stationary Hospital was anything but. Each Division had two, each holding about 400 wounded but they needed to be able to move with their Division. They often took over civilian hospitals or suitable buildings. General Hospitals were located next to railway lines going to the ports. Large buildings, such as hospitals, hotels or even casinos may be used. Full hospital services, including x-ray and civilian treatment was available. Base Areas were areas such as Boulogne and Havre, stopping off locations before returning to Britain. These areas had full hospital facilities. The RAMC, although not a fighting force, had a major role in the outcome of the war on the Western Front. Through the skills and quick actions of its members it was able to return about 1.6 million wounded soldiers back to the front. A vast amount of manpower saved. |
© Alan Graham 2021