426 - The Surgical Legacy of World War II - Part 3: Blood and Valor

On June 6, small teams from the 3rd ASG came ashore with the troops in landing craft, parachuted or flew in on plywood gliders with the Air- borne, with most men crashing hard to the ground. They relied on help from the Naval hospital tent erected on the beach to treat the staggering number of the wounded, whose blood colored the sea and sand red. Medi- cal personnel could do nothing more than control blood loss and wait for help – both military and medical. The paucity of supplies that successfully made it ashore significantly hindered the options available to the surgical teams. The commanding officer’s account of D-Day operations to the Surgeon General is a terrifying tale of fiery gliders falling from the sky, supplies lost at sea, buildings collapsing upon makeshift operating tables, and munitions exploding all around them while treat- ing the unceasing flow of wounded. The first makeshift ORs were set up in barns nearby using whatever medical sup- plies they could scavenge from what survived their landing. Other small units from the 3rd ASG would arrive the next day (D-Day +1) on the Normandy beaches. The 3rd ASG maintained meticulous records of their patients and the surgeries they performed starting on June 6, 1944, through December 1, 1944, serving 13,162 surgical patients that entered the tent flaps of the 3rd ASG, which on D-Day +22, was given additional equip- ment, personnel, orders, and a new name: Mobile Army Surgical Hospital (M.A.S.H.) - the first M.A.S.H., and the group was dispatched deeper into in France. The 4th ASG arrived on the shore of France on D-Day T he US Army Blood Program began in 1940, and by 1941 dried plasma was deemed safe for use. Because plasma in this form has a long shelf life, is lightweight and does not have to be type-specific, it easily could be reconstituted in remote locations where whole blood was not available. It was a major breakthrough in the treatment options for shock. By the time the US landed in Normandy, the US Army Blood Program and civilian pharmaceutical companies had collaborated to invent novel methods for banking whole blood, and for preserving, shipping, and administering other blood products and blood substitutes. There is a version of this program still in operation to support servicemen and women deployed in combat theaters. “In World War I, men died without surgery because the means of resuscitation were not available. In World War II, men sur- vived because they were operated on, but the fundamental reason for their survival was that they lived or, more correctly, were kept alive until they were fit to be operated on. They were kept alive by plasma until they could be given whole blood. They were resuscitated – which means, literally, brought back to life – by whole blood, which made operation possible. Very often they were kept alive during operation by the continued use of whole blood. Finally, many times, their recovery after operation was expedited by the use of whole blood, even if it was not again necessary to keep them alive.” — Brigadier General Douglas B. Kendrick, Jr., 1962 T HE BL OOD PROGR AM OF WWI I Medics attend to wounded soldiers on Utah Beach in France on June 6, 1944. Photo credit:USMilitary JUNE 2019 | The Surgical Technologist | 257