​As we at Newcross prepare to commemorate those who gave their lives in conflict we take a look at how despite the horrors of the trenches and the battlefields World War One revolutionised healthcare.

Healthcare is constantly changing in every regard both in terms of the needs of individuals and the ways in which care is delivered. History has taught us that it's essential for the review of techniques and processes to be both ongoing and integral to care provision. Innovation can never be an afterthought.

The old maxim that 'necessity is the mother of invention' is particularly apt in healthcare and some of the most important improvements have been born out of the most challenging circumstances.

At the outbreak of the war, all sides expected that the conflict would end quickly but as we all know World War One dragged on for four bloody years. By the end of the war, nine million soldiers and seven million civilians would be dead.

Nursing and women’s rights

The first World War was a major turning point for women’s rights. For decades prior to the war, several movements such as the Suffragettes had been calling for the right to vote and more equality. With the outbreak of war and with so many men sent to the frontline women stepped up to do jobs vacated by men that were vital to the war effort. From factories to farms, women worked in them all. It was the first time in history that women had been mobilised on such a scale and thousands of nurses both professionals and volunteers travelled to the Western Front to play a vital role in providing medical care to the wounded.

At the start of the war the military relied on nurses from the Queen Alexandra’s Imperial Military Nursing Service (QAIMNS), but in 1914 it had less than 300 nurses available. At the time the British army was opposed to using any female nurses from outside of QAIMNS, so any women wanting to help had to join the nursing services of the French or Belgian armies. As the casualties mounted the British army relented on its opposition, and by wars end, there were over 10,000 nurses in service.

Did you know? Throughout much of the early part of the war doctors and nurses had to rely on salt water to clean wounds

Motorised ambulances

In the first few months of the conflict, wounded soldiers were taken from the battlefields via mule or horse-drawn wagons and then to train stations and finally to hospitals that were often miles away from the frontlines. In many cases, wounded soldiers were left outside exposed to the elements for days at a time as they waited for pickup and transportation. This slow process claimed the lives of many soldiers. To counter this, civilian volunteers donated motor vehicles to be converted into ambulances. The British Red Cross eventually created a form of standardisation which made it possible for ambulances to be ordered directly from manufacturers and before the wars end a fleet of motorised ambulances was in use by the Allies on the Western Front.

Antiseptics and anaesthesia

At the start of the war, there was a severe lack of skilled surgeons and antiseptics. As a result of high rates of infection, a huge number of amputations took place. According to records, over a six week period over 300,000 French were wounded and out of those, 20,000 received amputations. After the war, French surgeon Théodore Tuffier testified to the Academy of Medicine that 70% of amputations were a result of infections and not initial combat injuries.

Due to the filthy conditions of the front, a British doctor was quoted as saying ‘every gunshot wound is more or less infected at the moment of its infliction’.

Due to soldiers living in the squalid conditions of the trenches, the rate of infected wounds was extremely high. The bacteria Clostridium perfringens in particular caused rapid necrosis known as ‘gas gangrene’. Henry Dakin, a British biochemist, tackled the problem and developed a new antiseptic – sodium hypochlorite that proved effective against the bacteria. Advances were also made in the use of anaesthesia with US doctors developing new methods that were effective at putting a patient to sleep without putting them into shock. Using these new antiseptic and anaesthesia methods, surgeons were now able to perform surgery without the risk of infection. These new techniques saved many lives.

X-rays

The brilliant scientist and pioneer Marie Curie watched the war unfold with horror. As someone with humanitarian leanings, she was appalled at the number of casualties being inflicted in the war. As a result, she was determined to help lessen the suffering and launched a project to provide a radiological service to the French army. Thanks to her efforts, x-ray machines were brought closer to the battlefields, and she acquired vehicles that were converted into mobile x-ray machines.

Blood Transfusions

World War One also saw a breakthrough in blood transfusion techniques. Physicians had been attempting blood transfusion for over 200 years prior to the outbreak of the war, and it was during the conflict that the technique was popularised among medical professionals. Oswald Robertson, a British born American officer, is credited with setting up the world’s first blood depot.

Despite the tragedy of the Great War, some good did emerge from the bloodletting. Many of the medical techniques, procedures and technologies that we take for granted today were created as a direct result of the conflict.

Author: Juliette Millard leads our Clinical Governance team, comprising nurses and clinical advisers who are tasked with supporting healthcare workers, promoting technical excellence and maintaining best practice. Innovations in frontline care including processes, administration are developed and overseen by Juliette's team.