Lesson video

Hello, I'm Mr. Marchant, and I'll be your history teacher for today's lesson.

I'm really excited to have you joining me as we explore today's subject.

And my number one priority will be to help ensure that you can meet our lesson objective for today.

Welcome to today's lesson, which is part of our Edexcel unit on medicine in Britain.

By the end of today's lesson, you'll be able to explain how medical care was organised at Casualty Clearing Stations and Base Hospitals.

There are three keywords which will help us navigate our way through today's lesson.

Those are ward, dressed, and moribund.

A ward is a room in a hospital where people receiving treatment stay.

Dressed, in this context, means to clean an injury and put a covering over it to protect it.

And moribund refers to something that is at the point of death.

Today's lesson will be split into two parts.

And we'll begin by focusing on Casualty Clearing Stations.

Fighting on the Western Front produced mass casualties.

It was important for those suffering from severe wounds to receive emergency treatment like surgery quickly.

Surgeries were performed most often in Casualty Clearing Stations, otherwise known as CCSs, making them critical locations for medical treatment on the Western front.

Although Casualty Clearing Stations were not the closest medical facilities to the frontline, they were the first place where surgeries could be performed.

This was partly because CCSs were located a safe distance away from battlefields, so they did not come under attack.

CCSs were also well staffed by teams of doctors, surgeons, nurses, and additional support staff who could provide a range of medical care to their patients.

Furthermore, CCSs were well equipped with operating theatres, their own wards, where patients could rest and recover, and occasional access to mobile x-ray machines.

So thinking about what we've just heard, which of the following was not a reason why surgeries took place at CCSs? Because they had appropriate medical facilities, because they were located very close to the frontlines, or because they had large and varied medical staff? Pause the video here and press play when you're ready to see the right answer.

Okay, well done to everybody who said the correct answer was b.

CCSs were not located very close to the frontlines, and so this was not a reason why surgeries often took place there.

During major battles, CCSs could face overwhelming demand from mass casualties.

It was critical to ensure that resources were focused where they would have the most benefit.

So CCSs set up a triage system, which typically divided patients into the following three categories.

The walking wounded.

These men had wounds which did not require critical treatment.

They would usually have their wounds washed and dressed by a nurse and be allowed some time to rest before returning to fight on the frontline.

Then there were serious cases.

This included men with life-threatening injuries who required immediate surgery.

Surgeons in a CCS had to be adaptable as they had to perform a wide range of operations, including setting broken bones, removing bullets and shrapnel from the body, and performing amputations.

Many of these patients would then be moved onto Base Hospitals once their condition stabilised.

And finally, there were the severely wounded.

This group was made up of men whose wounds was so serious that they had no chance of survival even if they were operated on.

These men were placed in separate moribund wards, where they would be made comfortable but were only cared for by nurses and priests, allowing doctors and surgeons to prioritise other patients who could be saved.

So let's make sure we have a secure understanding of everything we've just heard.

What system was used to categorise patients at CCSs? Pause the video here and press play when you're ready to see the right answer.

Okay, well done to everybody who said that a triage system was used to categorise patients at CCSs.

And now I want you to change one word to correct the following sentence, which reads, the walking wounded usually had their wounds dressed at CCSs before returning to hospitals.

So consider which word seems to be incorrect in that sentence and what should it be changed to.

Pause the video here and press play when you're ready to check your answer.

Okay, well done to everybody who said the incorrect word in that sentence was hospitals and that it should have been changed to fight.

The walking wounded usually had their wounds dressed at CCSs before returning to fight on the frontlines.

And now we have a statement which reads: individual surgeons had to perform many different types of operation in CCSs.

But is that statement true or false? Pause the video here and press play when you're ready to see the right answer.

Okay, well done to everybody who said that that statement was true.

But we need to be able to justify our response.

So why is it that that original statement was correct? Pause the video here and press play when you're ready to check your answer.

Okay, well done to everybody who said patients with a wide range of injuries were sent to CCSs, so surgeons had to be adaptable and perform many different operations, such as setting bones, removing bullets, and amputating limbs.

And finally, we have a question which says: where were the most severely wounded patients sent to in CCSs? Was it moribund wards, operating theatres, or wards for rest and recovery? Pause the video here and press play when you're ready to see the right answer.

Okay, well done to everybody who said that the correct answer was a.

The most severely wounded patients who had no chance of recovery were sent to moribund wards in CCSs, where they would be cared for but only by priests and nurses so doctors and surgeons could prioritise their time on patients who could be saved.

So now we're in a good position to put all of our knowledge about Casualty Clearing Stations into practise.

We have an extract.

It comes from a speech made by Richard Clarke, who led a CCS during World War I.

In the extract, Clark says, "For every case, I had to decide where to send the patient; either to a ward for rest, to a ward especially kept for the dying, or straight to one of the surgical wards.

My problem in a battle was to keep all the surgeons busy only with cases urgently needing operation." So we're gonna split Task A into two parts.

Firstly, I want you to identify a quote from the extract which demonstrates how the triage system worked in Clarke's CCS.

And then I want you to explain why triage systems were necessary in CCSs.

So pause the video here and press play when you're ready to reflect on your responses.

Okay, well done for all of your hard work on that task.

So firstly, I asked you to identify a quote from our extract which demonstrates how the triage system worked in Richard Clarke's CCS.

And your answer may have included: "I had to decide where to send the patient; either to a ward for rest, to a ward especially kept for the dying, or straight to one of the surgical wards." This shows how triage systems were used to organise patients, dividing them into different categories so that they could receive different kinds of treatment.

And then I asked you to explain why triage systems were necessary in CCSs.

And your answer may have included: triage systems categorise patients in CCSs, determining what type of care they would receive.

For instance, patients who needed life-saving surgeries were separated from those with less critical wounds and those with severe wounds who could not be saved.

This was necessary because it ensured that surgeons and doctors spent their time where they would have the most impact, especially during major battles.

Whilst doctors and surgeons focused on life-saving operations, nurses often led the care for the walking wounded, whose wounds would be dressed, and for those who could not be saved, who were sent to moribund wards.

So really well done if your own responses looked something like those models which we've just seen.

And so now we're ready to move on to the second part of our lesson for today, where we're going to think about Base Hospitals.

Once their condition had stabilised at Casualty Clearing Stations, those who required further treatment were sent to Base Hospitals.

British Base Hospitals were even further away from the frontline than CCSs and could provide wide-ranging care over long periods of time to wounded soldiers.

Base Hospitals were locations where patients who required more complex or prolonged treatment could be cared for.

Most were located close to the Belgian and French coasts.

However, whilst Base Hospitals were far away from the frontline, they were well connected by railway lines, which allowed them to receive many patients from CCSs, and by ports, which allowed some patients to be sent back to Britain by ship.

Base Hospitals were typically set up in large converted buildings, like former hospitals or colleges.

Base Hospitals were well equipped with their own operating theatres, wards, laboratories, and radiology departments with x-ray machines.

These facilities helped ensure a high quality of care could be provided at Base Hospitals, as did the staffing, which included teams of doctors, surgeons, nurses, and other support workers.

Base Hospitals generally cared for a wide range of patients, but some did have specialist wards which focused on particular types of injuries.

For instance, the Base Hospitals at Calais, Rouen, and La Havre had trained staff and specialist equipment to help them treat patients suffering from fractured femurs.

Over the course of World War I, Base Hospitals grew larger in response to the mass casualties suffered on the frontline.

Whereas 10,000 patients could be accommodated across all British Base Hospitals in 1914, this had grown to nearly 100,000 by the end of the war in 1918.

The largest individual hospitals had as many as 2,500 beds.

All these factors helped ensure treatment was generally successful at Base Hospitals.

Records suggest that over 80% of patients sent to Base Hospitals survived their wounds.

Some of these patients then returned to fight on the frontline, whilst a greater number were relocated to Britain to receive further treatment there.

So thinking about what we've just heard, I want you to identify two things Base Hospitals were normally located close to.

Was it coasts, railway lines, the frontline, or trenches? Remember, you're selecting two answers to this question.

So pause the video here and press play when you're ready to see the right answers.

Okay, well done to everybody who said the correct answers were a and b.

Base Hospitals were well connected because they were normally located close to coasts and railway lines.

And now we have a statement on the screen which reads: each base hospital specialised to treat certain types of wound.

Is that statement true or false? Pause the video here and press play when you're ready to see the right answer.

Okay, well done to everybody who said that that statement was false.

But we need to be able to justify our response.

So why is it that that original statement was incorrect? Pause the video here and press play when you're ready to check your answer.

Okay, well done to everybody who said Base Hospitals mostly cared for a wide range of patients, but some did have specialist wards which focused on particular types of injuries, like fractured femurs.

And how can historians tell that treatment at Base Hospitals was mostly successful? Is it because they could accommodate 10 times more patients by 1918, because over 80% of patients either returned to fight or to Britain, or because the largest ones had up to 2,500 beds? Pause the video here and press play when you're ready to see the right answer.

Okay, well done to everybody who said the correct answer was b.

Historians can tell that treatment at Base Hospitals was mostly successful because over 80% of patients survived their wounds and either return to fight or to Britain for further treatment.

Hospitals were not only set up far away from the frontline on the Western Front though.

In Arras, where British forces fought a major battle in 1917, a fully working hospital was even built underground, just 800 metres from the frontline.

Indeed, a huge network of tunnels was constructed underground at Arras from the end of 1916 onwards.

These tunnels provided a space where troops could move and rest safely but also provided enough room for a fully functioning hospital to be built, with several operating theatres, wards for 700 patients on stretchers, waiting rooms, and a mortuary for the dead.

The underground hospital was also supplied with both electricity and piped water.

This allowed more casualties to be treated quickly than was possible elsewhere on the Western Front because the hospital was so close to the frontline.

However, during the 1917 Battle of Arras, a German shell destroyed the water supply to the underground hospital, leading to its abandonment.

So thinking about what we've just heard, where did the British set up an underground hospital? Was it at Arras, Cambrai, the Somme, or Ypres? Pause the video here and press play when you're ready to see the right answer.

Okay, well done to everybody who said the correct answer was a.

The British set up an underground hospital at Arras.

And now we have a statement on the screen which says: the underground hospital at Arras was abandoned because it was too small.

But is that statement true or false? Pause the video here and press play when you're ready to see the right answer.

Okay, well done to everybody who said that that statement was false.

But we need to be able to justify our response.

So why is it that that original statement was incorrect? Pause the video here and press play when you're ready to check your answer.

Okay, well done to everybody who said the underground hospital at Arras had large amounts of space and could accommodate 700 men on stretchers but had to be abandoned after it's hit by a German shell during the 1917 Battle of Arras.

So we're now in a good position to put all of our knowledge about Base Hospitals into practise.

Was the underground hospital at Arras a typical Base Hospital in the British sector of the Western Front? Explain your answer.

As part of your answer, you should consider both the similarities and differences between the hospital at Arras and other Base Hospitals.

So pause the video here and press play when you're ready to reflect on your response.

Okay, well done for all of your hard work on that task.

So I asked you, was the underground hospital at Arras a typical Base Hospital in the British sector of the Western Front.

And your answer may have included: most British based hospitals were fairly large so that they could accommodate large numbers of patients.

For example, by the end of World War I, 100,000 patients could be accommodated in total across all British Base Hospitals.

And the biggest had 2,500 beds.

In this sense, the underground hospital at Arras may be considered fairly typical as it was also quite large.

700 patients on stretchers could be cared for there.

The underground hospital at Arras was also well equipped, making it typical of Base Hospitals.

However, the underground hospital at Arras was very untypical in terms of its location.

Base Hospitals were usually located close to the French and Belgian coasts, far away from the frontline so that they would be safe from any attack.

By contrast, the underground hospital at Arras was just 800 metres from the frontline, placing it within close reach of the German army.

Indeed, whilst being underground offered some protection, during the Battle of Arras in 1917, a German shell destroyed the hospital's water supply and it had to be abandoned.

This also meant the hospital was not in use for very long, unlike other Base Hospitals.

So it was not very typical overall.

So really well done if your own response looked something like that model which we've just seen.

And so now we've reached the end of today's lesson, which puts us in a good position to summarise our learning about medical treatment in Casualty Clearing Stations and Base Hospitals.

We've seen that Casualty Clearing Stations used a triage system to manage the patients they received and prioritise their medical resources.

In CCSs, patients with life-threatening wounds were prioritised for surgery.

Those with less critical wounds would have them dressed.

And those who could not survive went to moribund wards.

Base Hospitals provided a wide range of effective treatment to large numbers of patients.

And an underground hospital was constructed at Arras but was abandoned after it was damaged during an attack in 1917.

So really well done for all of your efforts during today's lesson.

It's been a pleasure to help guide you through our resources today.

And I look forward to seeing you again in the future as we continue to think about medicine in Britain and medical history on the Western Front.