Syllabus Edition

First teaching 2024

First exams 2026

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The Chain of Evacuation in the First World War (Edexcel GCSE History)

Revision Note

Zoe Wade

Author

Zoe Wade

Expertise

History

The Chain of Evacuation in the First World War - Summary

Soldiers injured in the British Sector of the Western Front often needed transporting to better-equipped facilities. Many men were also sent back to Britain to receive further treatment in British hospitals. This system became known as the chain of evacuation.

To treat the large number of British casualties, there needed to be an efficient system. This system moved the wounded away from the frontlines to areas where they could receive treatment. There were four main stages of treatment:

  • Regimental Aid Posts

  • Dressing Stations

  • Casualty Clearing Stations

  • Base Hospitals

This system aimed to get as many soldiers back to frontline fighting as possible. Stages closer to the frontlines carried out minor treatment for soldiers to return immediately to the fight in the trenches. The RAMC and other medical groups had to transport the wounded between these stages.  The war effort depended on this system working effectively.

A  flowchart showing the medical evacuation of soldiers. Soldiers went to Regimental Aid Posts, Dressing Stations, then a Casualty Clearing Station, Ambulance Units and finally to Base Hospitals
A diagram showing the chain of evacuation on the Western Front

Regimental Aid Post

  • Regimental Aid Posts (RAP) were around 200 metres from the frontline

    • Located in communication trenches or deserted buildings

    • Wounded soldiers arrived by walking or on stretchers

    • Staffed by a Regimental Medical Officer and stretcher-bearers with first-aid knowledge

  • The purpose was to give immediate first aid:

    • Soldiers with more serious injuries were transported to Dressing Stations

Field Ambulance & Dressing Station

Field Ambulance

  • A mobile medical unit of the RAMC which treated around 150 wounded soldiers at a time:

    • The field ambulance was a group of RAMC medical staff, not a vehicle

    • The field ambulance at Hooge in the Ypres Salient helped 1,000 soldiers from 10-11 August 1917

  • They were also responsible for establishing Dressing Stations

Exam Tip

Don’t confuse the field ambulance with ambulance wagons:

  • The field ambulance was the unit of RAMC which set up Dressing Stations.

  • Ambulance wagons were the vehicles used to transport the sick and wounded.

Dressing Stations (ADS and MDS)

There were two types of dressing stations:

  • The Advanced Dressing Station (ADS) was around 400 metres behind the RAP

    • The Main Dressing Station (MDS) was around a mile behind the RAP

  • The dressing stations were:

    • Located in dug-outs or abandoned buildings to stay protected from artillery

    • Wounded soldiers arrived by walking or on stretchers

    • Staffed by ten medical officers, along with stretcher-bearers from the RAMC. From 1915 there were also nurses 

  • The purpose was to give emergency first aid to the wounded:

    • Those who required further treatment were transported to Casualty Clearing Stations (CCS)

Worked Example

Describe one feature of the Dressing Stations where injured soldiers might be taken to receive treatment

2 marks

Answers: 

Dressing Stations were around a mile behind the frontlines (1). This made it less likely for them to be hit by artillery fire (1).

Exam Tip

This question previously asked students to describe two features of a given event. This question was out of four marks. However, as of 2025, Edexcel will split this question into two subsections, asking you to describe a feature of two different events. Each subsection is worth two marks.

Remember to use separate sentences to identify the feature and to provide additional information. This is so the examiner can clearly see why two marks should be awarded for the feature.

Casualty Clearing Station

  • The Casualty Clearing Station (CCS) was a few miles from the frontline

    • They were located in permanent structures like factories or schools

    • CCSs were close to a railway line

      • This allowed rapid transport of the seriously wounded

  • Wounded soldiers arrived by ambulance wagons

    • The CCS were staffed by doctors and nurses who treated life-threatening injuries like limb amputations

  • The purpose was to divide the wounded using a system called triage:

    1. Walking wounded returned to the fighting after minor treatment

    2. Those who needed hospital treatment were sent to base hospitals

    3. Those who were so severely wounded that they were not going to survive. These soldiers were made as comfortable as possible until they died

  • The CCSs during the Third Battle of Ypres in 1917 were responsible for treating many wounded:

    • There were 24 CCSs in total

    • Staffed by 379 doctors and 502 nurses

    • Over 200,000 casualties treated

    • Only 3.7% of casualties died

Base Hospital

  • Base Hospitals were near the French and Belgian coasts

    • The Base Hospital was usually a civilian hospital or a large building

    • Wounded soldiers arrived by train or canal barge 

    • They contained many medical staff including doctors and nurses

  • The purpose was to give specialised treatment to wounded soldiers:

    • Most base hospitals had operating theatres, x-ray departments and treatment areas for gas poisoning 

    • Casualty Clearing Stations then used the techniques perfected in Base Hospitals 

  • Hospital ships transported soldiers back to Britain for further treatment 

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Zoe Wade

Author: Zoe Wade

Zoe has worked in education for 10 years as a teaching assistant and a teacher. This has given her an in-depth perspective on how to support all learners to achieve to the best of their ability. She has been the Lead of Key Stage 4 History, showing her expertise in the Edexcel GCSE syllabus and how best to revise. Ever since she was a child, Zoe has been passionate about history. She believes now, more than ever, the study of history is vital to explaining the ever-changing world around us. Zoe’s focus is to create accessible content that breaks down key historical concepts and themes to achieve GCSE success.