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Bardess, 4 February , 2017 in Medical Services (Home and Abroad)
APPENDIX NO 2
DETAIL OF ORGANISATION
The 47th Casualty Clearing Station was opened on the Champs de Manoeuvres, Hesdin. This is a long undulating piece of ground measuring half a mile in length and about a quarter of a mile in breadth; it is well sheltered by trees all round and runs from East to West. To the West of the site of the Camp the ground is very undulating and it is impossible to pitch Marquees there. The ground selected as suitable for camping and opening a Hospital of 500 beds is opposite the road in, which runs at right angles to the entrance to the Cavalry Barracks. The surface has a slight fall towards the North in the direction of the river, the ground is very uneven and cut up in places. The soil is of clay. Drainage holes made, perforated this stratum of clay at a depth of 6 to 7 feet and came upon the ground water, the water bearing stratum being composed of a black soil of peaty consistence.
The front of the Hospital is about a hundred yards from the end of the road leading in. A right angle was taken and a space of 100 square yards marked out. Four Hospital Marquees were pitched on the front line at proper intervals, facing South, the first being office and reception Marquee, No 2, Operating Marquee, No 3, Equipment Stores, No 4, Quartermaster’s Stores. Between Nos 2 and 3 the main street dividing the original Camp was arranged for.
The second line from the left consists of one Bell tent used as a Duty tent and to contain spare equipment and dressings. Next, four double Marquees were marked out with pegs so that, when erected, a long, continuous block might be formed, the roofs being lashed together end to end, one side overlapping the other to prevent rain from getting in. It was found that a distance of ten feet was required from the pole of one Marquee to the pole of the next. When these Marquees had been completed, the passage way throughout was almost continuous, there being little narrowing at the joins, and there was space for 50 stretchers, *two lines down the middle and the others at the sides, leaving plenty of gangway room. On the same line at the right side of the street two more single Marquees were pitched, one for the accommodation of serious cases and the other as a food Store. On the extreme right the operating tent was pitched and used as a Dispensary and Medical Store, [it was found that this tent was not large enough for operating purposes and an area to contain the accessories].
* 50 beds
**Lines 3, 4 and 5 were composed of two blocks, each of four Marquees lashed together. At the ends of each block were pitched two bell tents, one to be used as a Dressing tent and the other as a tent for Hospital equipment, blankets, clothing, necessaries etc.
**3 – 100 beds
4 – 100 beds
5 – 100 beds
360 beds TOTAL
The Hospital was subsequently extended East on the same frontage, ***three more blocks of four Marquees lashed together being erected, with corresponding Bell tents.
510 beds TOTAL
All the tents were trenched and surface drainage into small sumps in suitable positions was carried out.
INTERNAL FITTINGS OF THE MARQUEES
Flooring, canvas tent bottoms. Stretcher beds, fifty to each block.
FITTING OF STRETCHERS
Each Stretcher is fitted out with two blankets, two sheets, a soft pillow where available and the whole covered with a ground sheet, the underlying idea being that the patient who was awaiting evacuation could rest and not soil the blankets, and, in the event of his stopping overnight, he would be placed between sheets and the blankets preserved as far as possible from infection by vermin. This arrangement of fifty stretchers had also the advantage that stretchers could be piled on one another when the Ward was not full and used as seats.
Hurricane lamps in the Wards, acetylene lamps in the dressing and equipment tents. The Dressing and equipment tents were fitted out as equally as possible with the packing cases and boxes brought with the Unit and supplemented by tables. Other wood boxes were put together as cupboards with shelving by the Regimental Carpenter. The cases were then used as receptacles and cupboards.
The blocks consisting of four Marquees were numbered A to K and a staff detailed to each block. Each block was completely fitted out with blankets, sheets, ground-sheets, towels, flannel shirts, pyjamas, bowls, and sterilized surgical dressings. It was arranged that walking cases should be dressed in the Dressing tents and lying down cases in the Wards. The detail was left to the discretion of the Medical Officer and Nursing Sister concerned.
The Quartermaster was left to make his own arrangements as regards the storage of his equipment, and the medical equipment, panniers etc, were handed over to the Dispensers. Instructions were given as to the time when Stores should be drawn by the Sections.
The roadway as shewn in the plan was made by the Royal Engineers and carefully tested before being used. Arrangements for lighting the road were also made by them, these were found to answer perfectly.
A distinguishing flag was placed at the corner of the road opposite the entrance to the Cavalry Barracks and another distinguishing flag was placed opposite the Reception Marquee. Directing flags were also put up. Sign boards were erected in the streets of the village for the purpose of shewing convoys the way in.
Two sources. Water for ablution, this is pumped daily by the Unit from the river into a large tank and distributed by pipes to ablution benches. Water for drinking and dressings is brought daily by filter cart from the Infantry Barracks and stored in two corrugated iron cisterns which are refilled as often as may be necessary.
Ablution benches, latrines etc were built at the back of the Camp close to the line of trees and up to the hedge. The Thresh Disinfector and laundry were also placed as shewn in the plan and the kitchen arrangements to the right rear of the Camp, as far as possible from the latrines and to windward. An underground Incinerator was also dug about fifty yards further West and a turf incinerator also built to be used if necessary. The Royal Engineers put down concrete floors to the kitchen and ablution benches and roofed in all the structures mentioned. A Sanitary Squad collects all refuse, including excreta. The #Incinerator disposes of this. Urine is carted away daily by a tank Cart.
# Note infra. This could be used as a furnace for producing a supply of hot water. Plans have been drawn for this purpose.
It was found that there was a slight fall from the South to North, that is, from the front of the Camp to the ditch at the rear, and two long drains were dug leading into this ditch, branches were made from these main drains to the Marquee blocks, sump holes and trenches mentioned so as to take away any rain water which might run off the Marquees. Water from the ablution benches and laundry was also let into the ditch. The slop water from the kitchens was let into a large deep sump pit through a grease trap, this at the time of writing had not filled up but it is probable some further arrangements will have to be made.
It is contemplated building a special hut to be divided into two parts as an operating room and a dental or anaesthetic room, it being considered that in the Marquee previously mentioned the arrangements are not altogether satisfactory or up to date.
ARRANGEMENTS FOR DISPOSAL OF PATIENTS
Notification is given either by telephone or Motor Cyclist that a Convoy is due, the Messenger gives the approximate number of patients in the Convoy and it is settled by the Senior Medical Officer responsible for evacuation, as to what numbers come into this Unit and what numbers go into the other Medical Unit in this area. On the arrival of the Convoy the patients are removed from the Ambulances by the unloading party and in fine weather are placed on boxes forming seats, outside the reception Marquee. In wet weather arrangements will be made to accommodate them pro tem in the Section block on the left of the line facing South. A Medical Officer is detailed to allot batches to various blocks, he has in his possession a number of marked tin discs. He gives four of these at a time to four patients who are then taken into the Reception Marquee where there are four Clerks each with a form of Nominal Roll corresponding with the Admission and Discharge Book. Particulars are taken and the four Patients are assisted by Orderlies to the Blocks to which they have been allotted, their places being taken by four others, until the Convoy is disposed of. To prevent patients wandering to the Latrines etc and getting lost, pails are placed in the vicinity of the Reception Marquee behind Latrine screens and men requiring to urinate are directed there.
There are 50 discs for each Block and numbers sent to each Block are kept as equal as possible so that work can be equally distributed. The number of discs left over shows the number of vacant beds.
When all the patients have been disposed of, the four Clerks’ numbers are added together – this forms the number of the Convoy. Pending the arrival of another Convoy, these names are entered in the Admission and Discharge Book. The diagnosis is checked by the Field Medical Card and, if there is no diagnosis, it is obtained from the Medical Officer in charge of the Block. Section Wardmasters also keep a Ward Book with names and a check is obtained on the number of cases admitted.
Patients, as soon as they reach the Block are, if able to walk, taken down to the ablution benches with clean towels and soap, in batches and there wash. Patients who are too fatigued are washed in the Wards.
Before, or on arrival of a Convoy, as the case may be, the Cook is told the numbers he has to provide for. He has water boiling in Soyer’s stoves and, if a meat meal is ordered, it is obtained by Machonochie Rations. If long notice is given of the arrival of a Convoy and there is time, fresh meat is obtained and cooked in the Aldershot Oven, if not all used it is available cold for sandwiches. Generally speaking, where enough notice is given, fresh meat is provided but otherwise the Machonochie Ration is utilised, the tins being heated in bulk in the Soyer’s Stoves in water. In fine weather all walking cases are fed close to the kitchen and given seats on boxes or forms. Tea meals or breakfast meals are similarly arranged for.
The Medical Officer and Nursing Sister are present in the Block when patients are admitted and use their discretion as to whether patients will be dressed immediately or washed and fed first. The general rule is that patients are washed and fed first and then have their injuries dressed, but of course there are exceptions to this rule. Dressings are carried out either in the Dressing tents or in the Wards as the Medical Officer directs. Serious and dangerous cases are reported as they occur and the Specialist Surgeon sees all cases in which operation is deemed necessary. It is contemplated at present to perform operations of urgency only.
CONVOYS OF EVACUATION
On information being given as to the number of cases that can be evacuated, the Medical Officer whose duty it is, proceeds to the various Blocks and collects the number of patients who are fit to be moved and classifies them as “Lying down cases”, “sitting cases unable to walk” or “walking cases”. Before the Ambulances arrive, these cases are collected and, in fine weather, placed outside opposite the road in the grounds, or, in wet weather, in an empty Block. They are helped into the Ambulance and each patient has to show his Field Medical Card before entering the Ambulance. The discs are sent up with the patients and collected by the Medical Officer, these are handed in to the Office, so that it can be at once ascertained what beds are vacant and where. The Medical Officer also checks the numbers out. Any Special papers are handed over to the Medical Officer in charge of the Convoy and the figures of the Convoy notified to Headquarters in the usual way.
Patients are supplied as far as possible with clean linen and clothing. Verminous patients are cleansed as far as possible and kept separate. All dirty blankets, sheets etc are passed through the Thresh Disinfector, each Wardmaster arranging with the men in charge of the Disinfector as to when to take and when to remove articles for Disinfection. Small articles are washed by the Ward Orderlies and larger articles by the Washermen. Surgical Dressings used in the Dressing tents are sterilized in the Autoclave and handed out in packets. Instruments are also sterilized by each Block. Dirty dressings are collected and burnt in the incinerator.
Officers and Nursing Sisters are required to keep their stock of Equipment up and to draw from the Stores concerned as required, 10am daily being the hour appointed. Special articles are kept by the Quartermaster or Dispenser as the case may be, who keep accounts of the issues and receipts. Surplus equipment is kept at Quartermaster’s Stores and issued by him under directions of the Officer Commanding. It is endeavoured to make each Block as complete as possible so that in the event of the Unit being ordered to move, the Blocks could be packed complete and subsequently unpacked complete at its destination.
J S Warrack
Lieut-Colonel, RAMC T
Field Medical Card
Are there any examples of these?
18 hours ago, johnboy said:
Field Medical Card
Are there any examples of these?
Field Medical Card
Are there any examples of these?
HERE And HERE.
Somewhere I have an order to Chaplains not to fill the card out. No idea what they were writing but they left no space for medical information which doesn't bode well for the man's treatment.
Good description of the CCS, wish they all had something like this.
Thanks for those examples.
Very similar to the plan for 36 CCS, in style at least
Have you found a plan for 36 CCS @David_Underdown?
Well strictly speaking @TEW found it - see
Aha. It would be nice to see it on that thread too
I originally mentioned the 36 CCS plan in a May 2016 thread; Plans of Medical posts. Later on I found David's website trying to establish the location of 36 CCS and as David had done all the hardwork on 36 CCS and has a hi-res copy on site I thought I could leave it at that.
I could edit the Plans of Medical Posts thread to include a link to David's site?
I've also noticed that some diaries (DMS, DDMS & CCS) mention maps and plans that have been removed and placed with 'Maps & Plans' but quite how to plough through TNA to find those ones is a mystery at present.
I am just fascinated by them and think it's a pity that there are not more around
Maps extracted from WO 95 are in WO 153 a search of the series with "medical" and a few other search terms gives some likely candidates (and a few false positives). http://discovery.nationalarchives.gov.uk/results/r?_aq=medical OR casualty OR hospital OR ambulance&_cr=wo 153&_dss=range&_ro=any&_st=adv (this series has not been digitised)
Thanks, David. If only I still lived in the UK
I've come across a couple of plans in Australian unit diaries. Happy to post them here, if it's not off topic.
Please do b3rn [or start another thread highlighting which CCS it is]
Interesting posts. Wish I could find plans of No. 46 CCS in Proven. My great-uncle died there in October 1916. Talbot House in Pop has some in their first exhibition room, but weren't very forthcoming when I emailed them asking where they came from.
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