Syllabus Edition
First teaching 2024
First exams 2026
The Chain of Evacuation in the First World War (Edexcel GCSE History)
Revision Note
Written by: Zoe Wade
Reviewed by: Bridgette Barrett
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:
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. |
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
Examiner Tips and Tricks
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).
Examiner Tips and Tricks
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:
Walking wounded returned to the fighting after minor treatment
Those who needed hospital treatment were sent to base hospitals
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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