Battle of the Bulge: U.S. Medical Care

Evacuation by 1/4-Ton Truck in deep snow in the vicinity of Monschau and illustrates Medical Detachment personnel of the 393d Infantry Regiment, during the Battle of the Bulge. Picture from 324th Medical Battalion Unit History

U.S. Medical Care

Battle of the Bulge Memories needs to be added as a permanent link to the index as this is the second time the site has come up in searches for relatively obscure information.

This article, Medics in the Bulge by Ralph Storm provides a great overview, not only of medical care during the battle, but also throughout the European Theater of Operations (ETO).

Storm's article goes beyond medical unit organization and front line procedures with extended sections on typical medical cases such as trench foot, cold injury and combat fatigue.

A quote from medic Keith Winston of the 100th Division (note: the 100th ID was not at the Bulge but held the line to the south as other divisions were rushed north)  on casualty evacuation under ideal conditions:

 "A boy gets hurt on the line.  Within a minute or less a telephone message is sent back to our forward aid station, a distance of 300 to 1000 yards from the front, where a Sergeant and four litter bearers are always on hand.  They rush right up to the line with a litter." First aid with an emphasis on stopping bleeding and hopefully by the time the patient was stabilized another litter team will have arrived to take the wounded to " where a jeep can travel... anywhere from 25 to 300 yards, depending on conditions."

The Medics definitely were earning their combat pay even when they were not entitled to it until early 1945!

Aid stations were located 1 to 3 miles behind the front line, did not have beds and only had the bare essentials. A physician would look at the patient who was then sent to a clearing station farther to the rear with a note from the physician on a card, attached to a button hole in the patient's coat.

Be sure to read the piece on litter carrying in the article.  It is in the aid station section and describes the exhausting work.  During emergencies it was not unknown for the battalion surgeons would act as litter bearers.

 The clearing stations would probably still be in artillery range of the enemy but this was the spot that any emergency operation would be performed. Finally, the wounded are taken by ambulance to an evacuation hospital, "where first class attention is administered".

During the Bulge many of the hospitals had to constantly move. The 130th General Hospital at Ciney, Belgium (northwest of Bastogne), was caught up in the fighting just as they were moving out.

Again, I highly recommend this article as it contains a wealth of information and interesting insights such as how penicillin could be extracted from the urine of patients and reused and despite the U.S. Army being segregated a decision was made not to set up segregated hospitals due to the impracticability and redundancy.

Summary of Winston's description:

Front line medics:

• stabilize until litter team can pick up and carry to where a jeep can pick up the wounded.

Aid Stations:

• fist look by a physician and initial diagnosis performed.

Clearing Stations:

• emergency operations performed.

Evacuation Hospital:

• "where first class attention is administered"
• If a patient needed more than six months of care he was sent back to the U.S.  Less than six months, he would be kept in theater for a quicker return to his unit.  During the Bulge this time was shorted to four months (to be sent back to the States) due to the surge of casualties. 

Warfarehistorynetwork.com has a good article on the U.S. Army Medical Corps in WW2 and mentions Portable Surgical Hospitals (PSH's). Originally, I thought PSH's were the clearing stations described by Keith Winston but they were a little more specialized.

 From the article:

"These spartan PSH tents were set up to accommodate major surgery, sometimes so close to the front that they were under fire from the enemy. They retreated or advanced rapidly with the fortunes of war. A staff of a fully equipped PSH could disassemble and load tents, equipment, and personnel onto waiting trucks within two hours"

The "ideal" process for treatment in the Warfarehistory's article summarized:


Front Line medics:

• Treat where the wounded man fell.  
• This usually consisted of a shot of morphine to prevent him from going into shock, some sulfa powder to keep his wounds from getting infected, and a rapid bandage to stop the bleeding.

Battalion Aid Station:

• "perhaps a kilometer behind the lines". 
• Thorough first aid, diagnosis, and serious injuries stabilized. 

Collecting Station:

• Further back from the aid station.
• Serious casualties sent to a PSH (if available) or sent the wounded to a clearing station that consisted of 12 doctors and 96 enlisted men.

Clearing Station:

• "major medical surgeries could be performed in sanitary conditions before the worst cases were sent to an evacuation hospital."

Portable Surgical Hospital:

•   Major surgery, probably allowing for more complicated cases than a clearing station.
•   Sometimes located in range of enemy artillery.

Evacuation Hospital

• 12-15 miles behind the lines.
• "Seriously wounded were shipped to a general hospital as near to the home of the individual soldier as possible."

Overview

Compared to conditions in WW1 the mortality rate for a wounded soldier fell from a little over 8% to 3%.  During the Civil War the mortality rate was as high as 25%.

I'll begin reading and try to find information allowing a comparison between medical care available to the Germans at the Bulge.  To help this comparison any suggestions and comments are welcome.

Related Links

Link to the Bulge series index.

324th Medical Battalion unit history, from training to deployment and their actions during the Bulge.

Recollections from nurse Dorothy Steinbis Davis who served in a field hospital in the European Theater of Operations with the 7th Army.