EVACUATION: Field Dressing Station created to care for nonsurgical cases

to reduce evacuation from Corps area. 

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Reorganisation Of Medical Services In The Field 

 

The experience of operations in France and the Middle East had demonstrated that the design for medical services in the field was unsuited to the new style of land warfare. 

The Director General Army Medical Services appointed a committee to examine the organisation of medical services in the field. This was known as the Hartgill Committee after it’s chairman (12). The committee considered that there were four defects of the current organisation: field medical units were cumbersome, insufficiently mobile and not adaptable to the tactical situation; field ambulances did not possess adequate means of communication internally or with their parent formations; casualties were not distributed directly to appropriate units but passed through a channel of evacuation which caused congestion in the forward areas while insufficient transport led to delay in the distribution of casualties to selected centres; finally, surgeons, their assistants and equipment were located too far to the rear of divisions and corps. 

FAILURES OF MEDICAL SYSTEM: 
 

 

insufficient mobility, 

 

inadequate communications, 

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too many intermediate units between wounding and definitive treatment, surgery located too far from point of wounding. 

 

The committee revised the system of evacuation with the aim of reducing the number of staging posts through which a casualty should pass.

The main feature of this new system was the classification of the casualty as far forward as possible and evacuation from that point direct to the medical unit in the rear which would most adequately deal with his particular case (13). 

 

This led to a re-organisation of existing units (particularly field ambulances) and created new units (Field Surgical Units, Field Dressing Stations). The overall scheme is shown in Figure 5 (6). 

 

EVACUATION: limit number of medical units between triage and definitive treatment. 

 

 

 

 

 

 

 

 

 

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Fig 5. Revised Scheme of Evacuation (Hartgill Scheme). 

The duties of the Regimental Organisation in the collection and initial treatment of casualties remained unchanged. The Advanced Dressing Station (ADS), whilst much closer to the front line, replaced many of the functions of the MDS. Substantially greater emphasis was given to the sorting of casualties according to the nature of the wound, their general condition and the kind of treatment indicated. This extended to ensuring that casualties were evacuated and distributed according to the sorting process. 

Casualties were divided into Groups. 
 

Group 1 cases were those exhibiting severe shock and urgently in need of resuscitation. These were to be despatched immediately to the divisional Field Dressing Station (FDS) which had specific facilities for resuscitation, usually based on an attached Field Transfusion Unit. The Field Transfusion Unit was designed to provide a mobile blood transfusion unit expert in resuscitation. This consisted of one medical officer and 3 other ranks. 

Group 2 cases were those requiring immediate surgical attention (wounds of the chest, abdomen and cases of severe or complicated fracture).These cases were to be sent to the Advanced Surgical Centre (formed from the Corps FDS with a Field Surgical Unit (FSU) and FTU attached). 

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Group 3, the remainder and the majority were to be despatched to the CCS. 

The prime consideration of the ADS was that of mobility and therefore it was decreed that this unit should not be engaged in active treatment of cases. 

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