Medical Aspects of Chemical Warfare (2008) - The Black Vault

History of the Medical Management of Chemical Casualtiesfor the station personnel. The aid station could accommodate30 casualties, but rarely received morethan 12. 37,38 A separate dugout at one side typicallycontained two rooms for the bathing, emergency treatment,and reclothing of chemical casualties. The doorsto the dugouts were generally 3 feet wide and wereprotected by two tight-fitting blanket curtains placedat least 8 feet apart. The curtains, soaked with alkaline,glycerin, or sometimes hexamethylenamine solution,were adjusted so they would fall into place upon engaginga release. The first curtain was intended to beshut before the second was opened. It was hoped thatthe curtains would sufficiently gas-proof the dugout.A hand-pumped fire extinguisher filled with a sodiumthiosulfate solution was used to neutralize chlorine(Figure 3-13). 20,21,37However, gas-proofing with two blankets made itdifficult to rapidly exit a dugout, so early US manualsadvised against gas-proofing front line dugouts. Thisadvice was generally unheeded because the advantageof having a chemical-free environment in which tosleep and occasionally remove protective masks outweighedthe risk. The same Army manual stated thatFig. 3-13. Early attempts at collective protection during WorldWar I included the dugout blanket, which was used to coverthe doorways to dugouts.Reproduced from: Army War College. Methods of Defenseagainst Gas Attacks. Vol 2. In: Gas Warfare. Washington, DC:War Department; 1918.“medical aid-posts and advanced dressing stations;Company, Regiment, and Brigade Headquarters; atleast one dugout per battery position; Signal Sheltersand any other place where work has to be carried outduring a gas attack should always be protected.” 20,21The personnel on duty at a battalion aid stationnormally consisted of an MO, a dental officer if available,and from four to six medics. These were oftensupplemented by two runners and a litter squad assignedfrom an ambulance company. The number oflitter squads was increased if unusual activity wasanticipated and equipment and supplies to support casualtyrespiration were necessary. Battalion equipmentbeyond that furnished by logistics tables includedequipment for managing chemical casualties, such astwo 500-L oxygen tanks, suits of overalls, gloves, andmasks for attendants caring for chemical casualties,gas fans, alkalis, and sprayers used to clean out thegalleries that chemical agents had penetrated. 42Aid stations were established in banked earth,abandoned cellars, or dugouts because in the offensivephase there was no time to construct elaborateshelters. For the most part, the aid stations were small,dimly lit, and poorly ventilated. Medical personnel onduty in the aid stations were continually exposed tooff-gassing from the chemical casualties. When hospitalfacilities were limited, one small building wasused for dressing purposes and another for treatingchemical casualties. After treatment, casualties weremanaged in tents or on litters in the open. 40In the absence of sufficient equipment and water, aneffective method was developed for bathing chemicalcasualties. Under a shelter, rows of inclined planeswere constructed by placing litters on wooden trestlesof unequal height. The litters were covered with rubberblankets that drained into buckets at their lowerends. Above, suspended from wires, were flushersfor the eyes, nose, and ears. Watering pots containinga strong soap (alkaline) solution were used for theface. The staff was protected by chemical protectiveclothing and gloves. 43 At some hospitals, only selectedcasualties could be bathed and given special mouthand eye treatment because of water restrictions. Careat the battalion aid station was similar to that givenat equivalent stations in the trenches: wounds wereredressed and splints were adjusted, if necessary;hemorrhage was checked; and shock was controlledas much as possible. Chemical casualties were givenas much relief as practicable.Ambulance Company Dressing StationAt the minimum, the functions of an ambulancecompany dressing station were to receive, triage, andtreat casualties (control hemorrhage, treat shock, and93