Extract from my dissertation:
The field ambulance was born out of the experience of the South Africa
The field ambulance brought together the various elements of the RAMC in the forward areas. It sat behind the regimental establishment and forward of true surgical facilities, bridging this variable and challenging gap. It was immediately obvious, and painfully true, that for the casualty suffering the complex, multi-system trauma that modern weapons inflicted, any delay in reaching the surgeon’s table would have a consummate effect on survival.[5]
The RAMC training manual issued in 1911 [hereafter RAMC 1911] provides an insight into the expected role of the field ambulance during deployments.[1] With a nominal strength of 10 officers and 224 other ranks, the field ambulances of an infantry division, commanded by a Lieutenant Colonel, each contained three sections. Each section [A, B & C] was formed from two sub-divisions, a bearer section and a tent section. The bearer section, with 1 officer and 42 other ranks, was responsible for the removal of casualties from, and re-supply of, the RAP.[2]The tent subdivision, of 2 officers and 20 other ranks, would re-assess the casualty, begin any necessary treatment and provide shelter and comfort whilst awaiting evacuation down the line. It was in turn responsible for re-supplying the bearer sub-division. Each section had a transport element attached of a NCO and nine or ten other ranks of the ASC. A batman for each officer and an additional ASC driver for the cooks’ wagon completed the unit’s compliment. The three-section structure had been chosen to provide flexibility in deployment, allowing the detachment of a section to provide support to distant sub-units of the division. The expectation, at least in the AMS, was for future operations to be the small scale deployments required in policing an empire. With a high portion of the RAMC wartime strength being drawn from the reserves, clear instruction and guidelines were required to allow a rapid mobilisation, deployment and an efficient performance.[3] Despite the British Army's traditional dislike for doctrine, RAMC 1911 prescribes the employment of the field ambulance during operations; whether during offensive actions, an encounter action, an attack, a defensive or even a retirement. Whichever of these is considered it is explicitly clear that the field ambulance was to be employed as a divisional asset, under the control of the Administrate Medical Officer [AMO].[4]It is possible this was due to the relative lack of higher formations in the British Army of the day, but the size and therefore position and role of the field ambulance didn’t radically change during its lifespan.[5] Following basic military principles the field ambulance was expected to keep a reserve, therefore generally deploying itself with: “ (i) the whole bearer division or one or two sub-divisions in advance; (ii) the ambulance wagons working between the bearer division and the dressing station or advanced dressing station; (iii) the last named posts, formed by one or more tent sub-divisions with the medical store carts and water-carts of the section or sections;”[6] But, as per RAMC 1911, one field ambulance would only work in isolation if detached outside the division, the resources of all three field ambulances were expected to work together to provide the full range of medical facilities needed within the divisional area.[7] [1]War Office Royal Army Medical Corps Training 1911 (London HMSO, 1911), Chapter 15, pp. 102-124 [2]The general principle of the medical chain of evacuation is that the unit behind is responsible for the removal of casualties of the unit in front. This is also the default for responsibility for re-supply. [3]Only the Guards and Cavalry Divisions had field ambulances formed by regular soldiers [4]In all war time documents seen in this study the role is described as the Assistant Director Medical Services [ADMS] [5]The field ambulance has only recently been removed from the Army’s order of battle. It’s successor, the Medical Support Regiment has maintained the same basic structure and role, [allowing for advances in equipment], the change being justified by the more frequent Brigade level operations currently being conducted [6]RAMC 1911 p 104. [7]See Appendix 1 for a 1911 chain of evacuation.
[1]The Army Medical Services received their Royal Warrant in 1898.
[2]The Territorial Forces [later Army] has always been a key element of the Army Medical Services, accounting for around 80% of the current “war” strength. The relative junior rank of the proposer of the idea is the truly surprising element.
[3] In a lecture presented to the royal United Services Institute, Staff Sergeant Stapleton outlined the move to what was, in all but name, the field ambulance structure. For a transcript of the lecture, see Journal of the Royal United Services Institute, 46 (1902).
[4]Stapleton’s name for the unit was not adopted and his suggestion of the merger as a means of economising manpower was reversed in the formation of the field ambulance.
[5]This is still considered to be true of most trauma cases, medical staff talking of the “golden hour” as an outer limit of time from injury to definitive care. There have been efforts to support this with the “platinum ten minutes”, this is aimed at pre-hospital staff and is defined as the time span from time of injury to evacuation from the scene.
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Posted by: ambulance equipment | 30 October 2009 at 12:04 PM
Interesting article. Where else could anyone get that kind of information in such a perfect way of presentation.
Posted by: Term papers | 12 February 2010 at 12:14 PM