The artifacts they left behind provide fascinating glimpses into the work they did and why they did it. When war broke out in Augustthe Canadian Red Cross national headquarters office in Toronto found itself deluged by items ranging from raincoats and baseball uniforms to worn-out phonograph records and broken furniture, sent in by Canadians hoping the items could be put to use in aid of the sick and wounded soldiers the war must soon produce. Several months after the outbreak of a different war, in NovemberToronto millionaire E. Watt donated his boat — a foot motor cruiser — to assist the Royal Canadian Navy Volunteer Reserve with training.
Transfusion at the Start of the 20th Century Blood transfusion had been attempted throughout history but generally failed due to a variety of factors. Chief among these was the propensity of blood to clot, reducing its flow and clogging equipment used to transfer it.
Blood could not be stored and needed to be administered as quickly as possible. Bytransfusions typically involved connecting blood vessels of donor and recipient using India rubber tubing.
A method to suture blood vessels together was devised by Alexis Carrel in and improved by George Crile in These direct transfusion methods necessitated cutting through the skin to expose blood vessels.
This required great surgical dexterity, could take two to three hours, and demanded that donor and patient lie quietly side-by-side lest the connections be disrupted.
It was impossible to gauge how much blood actually passed from donor to patient, and clotting remained a major problem. Severe, sometimes fatal, reactions occasionally occurred and most were due to blood group incompatibilities.
Although ABO blood grouping was discovered in by Karl Landsteiner, it would be several years before its significance in transfusion was appreciated by most physicians.
Given the difficulties and unexplained reactions, interest and trust in transfusion had significantly waned by the turn of the century, especially among European physicians. Innovations in Transfusion, However, interest in transfusion remained higher in the United States, and in the years preceding the war several key advances were made.
Brown of Boston collected donor blood into a glass cylinder that had first been coated with a film of paraffin. Better still was the multiple syringe method devised that year by Edward Lindemann of New York.
A highly-choreographed team kept syringes in constant motion from donor to patient. Importantly, they used sharp-pointed metal needles inserted through the skin directly into the veins, eliminating the need to expose the blood vessels by incision.
Modifications replacing the syringes with tubing and stopcock devices simplified the process, making it possible for a single physician to perform a transfusion. Blood Bottles — World War I. About mL of blood was typically collected from each donor.
Prior to transfusion, excess anticoagulant was removed and the blood poured into a new bottle, filtering it through a gauze plug to remove any clots or debris.
The anticoagulant allowed blood to be stored for a few days and ended the need for donor and recipient to be in the same room. These methods might work at hospitals behind the lines, but were too delicate for military operations.
And, it was difficult to arrange sufficient donors and surgeons when multiple patients simultaneously required transfusion.
One of the greatest hazards of blood loss by the wounded was shock. When Canadian physicians joined the war in support of the British Empire, they brought with them the syringe and paraffin tube methods of blood transfusion.
Notable among the Canadians was L. Bruce Robertson from Toronto, who had recently trained with Lindemann in New York and who published his wartime transfusion experiences in the British Medical Journal inhighlighting the benefits of infusing blood.
British interest was piqued. Before the war, Lee, an early advocate of blood grouping, had sent Robertson to work with Rous at the Rockefeller Institute. Initially, Robertson used citrated blood drawn into one liter glass bottles, converting ammunition boxes into shipping containers, with sawdust and ice packed around the bottles.
He selected only group O blood donors, compatible with all other blood types, thus requiring no further testing. The citrated blood could only be stored a short time, but it allowed blood to be collected in advance of need.
Citrate and dextrose were sterilized separately, then mixed in a two liter bottle the larger bottle necessitated by the volume of dextrose needed.
Citrated blood usually without dextrose became the method of choice for most Allied medical forces, although paraffin tube and syringe methods each with a variety of adaptations were also widely used. Allied medical forces were issued standardized transfusion kits to carry into the field, allowing blood to be given even before transferring the injured to casualty clearing stations.
British Portable Blood Transfusion Kit. Kits designed by Geoffrey Keynes of the Royal Army Medical Corps generally did not use anticoagulants,so the blood was transfused soon after collection. Not all transfused blood was group O.
Lists of blood groups of camp personnel were maintained, to be summoned as donors were needed. Convalescing troops often volunteered as donors for more seriously wounded comrades.
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