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THE SELECTION OF FIELD AMBULANCE POSITIONS.

THE more important factors taken into account in selecting positions and assigning work to field ambulances may best be indicated with the assistance of a map. A division during quiet times might probably occupy a  three-brigade front such as shown previously in Fig. 4 and here repeated (Fig. 19), for the purpose of indicating the lines of evacuation of casualties under such local conditions.


The regimental aid posts of battalions in the fire trench are seen to be farther forward than those serving battalions in the reserve. Each has a field ambulance stretcher-bearer post beside it, with 4 bearers detached from the advance station to which its sick and wounded are evacuated. A relay post is shown on the right.


The field ambulance~ marked by a circle, is responsible for the brigade on the left, and has an advance dressing station, composed of one of its sections, in a village on the main road of that side.

 

From this point casualties, not in the category of seriously wounded (who are sent direct to the casualty clearing station) are conveyed by the ambulance cars to its headquarters, situated in another village a couple of miles to the rear. A second section operates this main dressing station, while the third runs a scabies hospital in an adjacent building.


The field ambulance, marked by a triangle, is responsible for the sick and wounded of the center and right brigades. It also has an advance and a main dressing station. The personnel of the former is composed of one section and supplies 4 bearers to the relay post as well as to each of the aid posts which it drains. The latter, having the casualties of two brigades to handle, retains 2 tent subdivisions and I bearer subdivision, while the remaining bearers are in rest, or possibly detailed to assist at baths.


It will be noticed that the right advance dressing station, in particular, is some distance from the frontline. A more forward position is impossible owing to the fact that the' two roads running toward the trenches are in full view of the enemy, from the slag heap behind his lines, and wheeled transport is therefore not permitted on them. If these roads were not so exposed the dressing station could not only be advanced but one could be established for each of the brigades.


The field ambulance, marked by an oblong, is not actively engaged in clearing the lines, but has charge of the rest station, and may, in addition, conduct some of the baths and possibly a laundry.

Fig 19.jpg

In the second map (Fig. 20) a division is shown as holding a front of small extent for trench warfare; there being only one brigade in the first line, with a second in the reserve, and the third in rest. The field ambulance, marked with an oblong, looks after the brigade in the fire and support trenches. The regimental aid posts are situated in a little valley about 1000 yards from the fire trench, and as the roads are good and exposed to
enemy observation at only one or two points, the ambulance cars can go up by day or by night.


The dressing station has established in this valley a stretcher-bearer post that can accommodate half a dozen patients for a short stay, and is connected with it by telephone, so that a small ambulance motor car can be sent up at any time. The advance station might be located at the site of this post were it not for the difficulty of keeping cars standing near it; and once this situation is decided against, it had better be placed in the
village as figured, as an additional half-mile or mile will, in this instance, make but little difference.


The field ambulance, marked with a triangle, attends to the brigade in reserve, and, not requiring an advanced position, operates only its main dressing station, together with the scabies hospital for the division.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


The field ambulance, marked with a circle, is responsible for the brigade in rest, and, like the other, has no advance station. In addition to its headquarters it looks after the divisional rest station.


With the preparation for an offensive the scheme of medical arrangements just studied will change into that illustrated in the third map (Fig. 21). 

 

Here the second brigade has been moved up to take part in the battle while the third is in the reserve line. An important consideration to the medical service is that only one good road is available for the transport of patients to the rear.


Thus, while two advance dressing stations are necessary to keep the aid posts clear, there is no object in multiplying main dressing stations, and one is therefore made responsible for all casualties that may be evacuated to it. In order to relieve both advance and main dressing stations a walking wounded station must also be established at some convenient point on the line of general evacuation.


The profound change thus made in field ambulance arrangements can be judged by the marked alteration in personnel which occurs. One field ambulance, marked with an oblong, is now made responsible for the evacuation of sick and wounded from the front lines. It operates the two advance dressing stations, and for this requires the assistance of the stretcher-bearers and their officers, together with the motor ambulances, of the other two field ambulances.

Fig 20.jpg
Fig 21.jpg

The second field ambulance, marked with a triangle, conducts the walking wounded station with its tent division. It has attached to it the horse transport of the other two field ambulances, in order to evacuate patients to the casualty clearing station. Should there be an advance and the line move forward, this transport will be used to bring walking wounded back to the station, whence they will then be conveyed to the casualty clearing station in lorries provided by the corps. The third field ambulance, marked with a circle, has charge of the
main dressing station. Its staff is supplemented by medical officers from the divisional train, pioneer battalion and certain army units, such as bridging trains not engaged. The personnel of the divisional band and concert troops are also attached to it to act as stretcher-bearers.


It will be noticed that one of the advance dressing stations is moved forward to the site previously discussed, which was occupied by a bearer post, thus resuming its normal place between hand and wheeled transport. The other, which attends to ,the right brigade, is also near the front. Both must find the necessary accommodation in dugouts.


It is evident that field ambulance arrangements hinge on the character of warfare and alter with it from quiet times to battle methods. The extent of line and the number of brigades holding it are also of much import. Behind all is local geography, with its considerations in regard to cover and enemy observation, roads, their number and condition, available buildings or sites for medical establishments, etc. These are all practical questions, to which the assistant director of medical services for the division makes practical replies by the proper placing of his ambulances and the correct apportionment of their duties. Even when this is done
to the best advantage he has not finished, for there yet remains the possibility of an enemy attack suddenly changing trench conditions in to active warfare, with the remoter contingency that it may be more or less successful. His arrangements for the moment must therefore always include a scheme for defensive operations.
To understand the plans that are made in anticipation of defensive warfare, an area occupied by a division under peace conditions, such as that before described, is referred to in the fourth map (Fig. 22).


The following measures would here be taken: 
(I) All stretcher-bearer posts are made large enough to accommodate a sufficient number of stretcher cases awaiting evacuation, so that the regimental aid posts may not be overcrowded.


There is the added advantage that such distribution of wounded lessens the chance of having many
killed. 

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(2) Arrangements are made with the officer in charge of the trench tramway that, if at all possible, it shall be made available for use by the stretcherbearers in clearing the wounded, and a certain number of cars fitted so that they will carry stretchers.


(3) Sign posts are painted directing the walking wounded to the station proposed for their collection and suitable points selected at which they may be erected if necessary.


(4) The commanding officers of the field ambulances are given full instructions as to the changes which must take place when they receive orders from the assistant director.


With the beginning of an enemy offensive in this area the probable medical rearrangement would be: 


(a) All detached personnel return to their field ambulances without further orders from the assistant director.


(b) The field ambulance, marked by a circle, responsible for the left brigade, remains as it is, but devotes its whole attention to its advance and main dressing stations.


(c) The field ambulance, marked by a triangle, responsible for the two right brigades, remains as it is and operates its advance and main dressing stations.


(d) The field ambulance, marked with an oblong, leaves one tent subdivision to look after patients in the rest station; sends its bearer subdivisions and motor ambulances to reinforce the field ambulance

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Fig 22.jpg

with the two right brigades, and with its remaining two tent subdivisions moves up and establishes a station for walking wounded , marked with an oblong, at a point where roads and tramway are convenient.


The horse transport of all three ambulances is placed at the disposal of this station for the evacuation of the walking wounded to the casualty clearing station, as under the circumstances it will probably be impossible to obtain lorries for the purpose. In any scheme for the evacuation of wounded following a surprise attack by the enemy it is very necessary that such should entail as little movement of units as possible. In the above the only marked change is the movement of two tent subdivisions of one field ambulance to establish a walking wounded station. The site chosen is the hutment built for a battalion in rest, so that the opening of this station
is easy, provided that the commanding officer of the field ambulance concerned has previously worked out the details.


If the enemy enforce his will and compel retirement to the line "A-B" the medical rearrangement is more radical.


(a) The field ambulance stretcher-bearers drop back as soon as the regimental medical officer opens a new aid post to the rear of his former position.


(b) The advance dressing station on the left retires along its main road for about 2000 yards, and again opens at a prearranged site in the little valley, marked with a double circle.


(c) The advance dressing station on the right falls back along its main road and takes up a chosen position, here shown as the former walking wounded station and marked with double triangles. This supposes both wings retire with the center, but should they hold while the center retires, and thus create an enemy salient, it may be thought advisable to open two advance stations on the right, the second being also shown by double triangles.

 

The commanding officer of the field ambulance will here be greatly influenced by weather conditions, as in
the position shown it would mean the evacuation of wounded by a third-class road.


(d) The walking wounded station takes up a new position, marked with a double oblong, at a point which now brings it into closer touch with the routes along which its patients will come. 

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