Northern European Front 1944 - 1945

 

The first steps in raising the medical component of the expeditionary force for the invasion of Northern Europe (15) started in January 1943. The findings of the Hartgill Committee defined the overall medical organisation from the outset of the medical plan. However, the management of casualties arising from the landing was the first challenge for the medical planners. The organisation tasked with the control of supporting military operations after the first ‘foothold’ had been achieved was the ‘Beach Group’. It was decided that within the Beach Group there should be a medical unit capable of affording first-aid treatment, including life-saving surgery, to ensure the immediate evacuation of the majority of casualties by sea to the UK with a reasonable degree of assurance that they would need no further intervention (Figure 7).

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Furthermore, these units should be capable of retaining casualties unfit for further evacuation in the short term. It was decided that the FDS and FSU combination was the best organisation for the task. They would then evacuate casualties ‘over the beach’ to designated ships that had completed the process of off-loading their military equipment and stores.

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This scheme was backed up with a comprehensive plan for the reception and distribution of casualties to hospitals within the UK. This was to be augmented by the evacuation of serious casualties by air as soon as forward airstrips had been established. In the event, the assault was less costly than had been envisaged and the medical services met the task without serious mishap. Evacuation by air began on June 13, a week earlier than planned, which shortened the period that serious casualties were retained in field hospitals.

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EVACUATION: specific medical systems may be designed for specific military operations,

though the principles remain valid.

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The casualty evacuation chain laid down by the Hartgill Committee provided the flexibility for the medical commanders to design a plan to support the campaign in Northern Europe until the end of the war in May 1945.The reduced size of the CCS was adequate for the task and could be reinforced by one or more Field Surgical Units if required. This ensured that the CCS remained sufficiently small to be moved by a single platoon of three-ton lorries (17).

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During the autumn and winter CCSs were accommodated in buildings and paradoxically took longer to establish (4-12 hours) than when set up in fields (2-6 hours).

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Fig 7. Medical Layout for a Beach Landing (17).

There was general agreement that surgery should not be undertaken too far forward, certainly not within the noise of friendly artillery or within the range of that of the enemy (18). When this limitation was not possible, on a beach or a drop zone, only those casualties of the highest priority were likely to benefit from such surgery.

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The exact design depended on the size of the units, the proximity of the enemy and risk of air attack.

 

SURGERY: should be done in a stable, secure environment ie. CCS not field ambulance.

 

Where risks were high, units were dispersed so that the consequences of a direct hit would be limited to single elements. This militated against internal efficiency and exposed the casualties to the external weather when moving between departments.

 

SECURITY: dispersal of unit as means of protection.

 

Whatever the size of the facility, the basic organisation followed a similar pattern. The casualty was received into the reception station. It was vital that this area had adequate space. The evacuation department was usually located close by to reduce the distance the numerous, less serious cases had to be carried. The pre-operative ward (also called resuscitation) was run under the direction of the transfusion officer. This person was entrusted with the responsibility for pre-operative diagnosis and treatment and the administration of blood or other fluid for the treatment of shock.

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The collation of the serious cases into one area also assisted the surgeon in the assessment of priorities for surgery. The X-ray set was also located in this area. The layout of the operating theatres was dependant on the size of the parent organisation and the number of operating teams.

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