Work of a Field Ambulance in the Battle of Normandy
Authors: F. S. Fiddes
Journal: BMJ (1945)

The title of this article has been chosen for convenience rather than accuracy, for it is proposed merely to give a statistical review of the cases handled in the advanced dressing stations successively established by the headquarters company of a field ambulance during the period July 1 to Aug. 24, 1944. It is not intended to discuss the tactical and administrative con siderations which are so important in the field, or to describe the layout adopted or the scope of medical work attempted. The arduous and often gallant work of the bearer companies will receive no more than this passing mention, as will the work of the ambulance drivers, whose scarred vehicles bore witness to their hazardous employment. It is gratifying, how ever, to be able to record that in all respects the training and planning of the waiting years were proved sound and well adapted to meet the strain of actual war. The period under review has been arbitrarily entitled the Battle of Normandy. It began with the earliest attempts to break out of the bridgehead, which, though still small, was well established by the end of June. It included a spell of very bitter fighting in the vicinity of Caen and on the Orne River. It ended with the virtual closure of the Falaise Argentan gap and the liquidation of the German Seventh Army. During the 55 days thus covered an advanced dressing station was fully established and open on 45 days, on seven successive sites. The remaining 10 days are accounted for by three days in rest and seven days occupied in movement or in harbouring during movement. The total number of cases handled was 2,641, of which rather more than half (1,476) were attributable to battle conditions (battle wounds, battle accidents, and battle  exhaustion  cases), and rather less than half (1,165) were of incidental origin (accidental injuries, sick and dental cases). The average number of cases dealt with while in action was therefore 55 to 60 a day, the greatest number on any single day being 250. With the personnel and equipment available, it is considered that 250 cases in one day is about as many as can be handled by the headquarters company of a field ambulance without loss of efficiency, especially if that total includes a high pro portion of battle casualties and if resuscitation is being carried out in the cases which require it. This is not to say that greater numbers have not been dealt with within 24 hours with the assistance of reserve bearer company personnel, but as a general statement it is probably correct. Seriously and exten sively injured men need handling with skill and care, and adequate first-aid measures in such cases occupy a consider able time. That the expenditure of time involved is worth while was repeatedly made obvious by the extraordinary improvement in the patient's general condition after careful manipulation, adequate dressing and splinting, ingestion of fluid, and the short rest, quite apart from the beneficial effects of transfusion in those cases in which it was considered necessary. Type of Casualty and Disposal The categories into which the various  casualties  fall and their disposal are summarized in Table I.