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

The chain of evacuation in the First World War - Summary

• The chain of evacuation was the organised system for treating and moving wounded soldiers from the frontline to better-equipped facilities

• It aimed to:

  • Return as many soldiers as possible to the fighting

  • Treat more serious injuries away from the frontlines

• It involved four key stages:

  • Regimental Aid Post (RAP)

  • Dressing Stations

  • Casualty Clearing Stations (CCS)

  • Base Hospitals

• The RAMC oversaw treatment and transport

Regimental Aid Post

• 200 metres from the frontline

  • Wounded soldiers arrived:

    • On foot

    • By stretcher

• Often located in trenches or abandoned buildings

• Staffed by:

  • Regimental Medical Officer

  • Stretcher-bearers

• The purpose was to:

  • Provide immediate first aid

  • Send more serious cases to Dressing Stations

Field ambulance & dressing stations

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

• They were also responsible for establishing Dressing Stations

Dressing Stations (ADS and MDS)

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

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

• Wounded soldiers arrived:

  • On foot

  • By stretcher

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

• Staffed by:

  • Around 10 medical officers

  • RAMC stretcher-bearers

  • Nurses (from 1915)

• The purpose was to:

  • Provide emergency first aid

  • Evacuate the seriously injured to the CCS

Casualty Clearing Station

• Located several miles away from the frontlines, near railways for transport

• Created in permanent structures like:

  • Factories

  • Schools

• Wounded soldiers arrived by ambulance wagons

• Staffed by:

  • Doctors and nurses, equipped by serious injuries

• Used a triage system to prioritise patients:

  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 24CCSs during the Third Battle of Ypres in 1917 were responsible for treating over 200,000 casualties

Base Hospital

• Located near the French and Belgian coasts

• Based on large buildings or converted civilian hospitals

• Wounded soldiers arrived by:

  • Train

  • Canal barge 

• Staffed by:

  • Doctors

  • Nurses

  • Specialist teams

• The CCS had:

  • Operating theatres

  • X-ray departments

  • Gas treatment areas

• Some soldiers were then transported back to Britain by hospital ship