<i1}t j/ohn Qiazettt 0) . " .
ijI;lye ®ffiriRI Jfonrnal of flye 09ra:nb Jriorll in tlye Realm of 31 enerah12 ®rber of fbe 'Y-joz .jJital of Jfolyn of Jjeruzalem
Edited by GEORGE E. CRAFT, O St.J , F.R.S.A.
VOL. 20. No.4.
CHIEF COMMISSIONER BRIGADE AT HOME APRIL, 1947.
EDITORIAL
As and from Ap ril I, I94 7, Lieut.-General Sir H enry Po K.C.B., K.B.E ., D.S.O., will be Chief Commissioner, Brigade At Home. Following the resi gnation of Sir J ohn Duncan in I 942, Gene ral Sir Clive Liddell (Director of Ambulance) was asked to take over the Briga de and since April, 1943, he has b een Acting Chief Commissioner. During that time Sir Clive lias b ecome known to many counties and has carried o ut his duties in a manner which has brought further efficiency to the Br igade as a whole.
In Apri l, 1946, he introduced Lieut.-Gene ral Sir Henry Pownall as his Deputy. Sir H enry, in his quiet una ssum ing manner, has studied the complicated machinery of the Brigade, has visited numerous counties and attended many inspections, ready f or th e tim e when he wo uld follow in the footsteps of other great leaders
T o Sir H enry we give a si ncere and hearty we lcom e as Chief Commissioner; to Sir Clive we extend thanks for the task which h e has carried out during the difficult years of the war.
Sir Clive Lidd ell will continue to b e the Director of the Ambulance D epartm ent of th e Ord er .
JOINT WAR ORGANIZATION
The J oin t War Organization of the British Red Cross Society and the Ord er of St. John continues with many of its w ar-time activities until Jun e 30, 1947. After that date many services will ha ve b een complet ed; but many, commenced during the I 91 4- 18 war, will still be carried on.
For this purpos e a ] oint Committee of the Ord er of St. John and British Red Cross Society has been formed and this Committee, run on similar lines as the War Organization, will undertake the services still to be run. These will include the Hospital Libra ri es, th e Hom e Service Ambulance, Emergency H elp Sch eme, After Care, etc .
St. John personnel will still be nec essary to carry out these activities; and County Committees have b een, or are b eing , formed so that the work will continue without delay.
SMARTNESS ON PARADE
Although the Brigade is not a military organization, it is very nec ess ary that when numbers of men and women, boys and girls, parade in uniform they should give a smart and neat appearance and be able to perform elementary movements in drill. Uniforms are to-day, thanks to rationing, showing the signs of hard wear; but a well brushed uniform, clean dress es, and the like hides many of the defects. It is suggested that at every divisional meeting a short time be spent in carrying out some form of drill. This applies just as much to women and to men; and the subsequent improvement on the parade ground at the annual inspections will well repay the time spent.
W:q£ ttt
On Thursday, March 6, a Special Chapter was held the St. Andrew's Cathedral, Sydney. The occasion was the lllstall.atIOn of Pnor of the Pribry by Lord Bledisloe as the Envoy of the Grand .Pnor.
This was the first occasion that a Priory Overseas ha.d recelved a .Vlslt.abon, and it was regretted that owing to illn ess Prior, Major-General SIT Wmston Dugan (Acting Governor-General of AustralIa), was unable to be ,Present.
The Procession to the Cathedral was headed by the ProcessIOn Marshal, followed by the Order's Cross, Chaplain, the St.andard, Representative of the Order, Commanders of the Order, Kmghts of Order, the :r:'nory Secretary, the Director of Ceremonies, the Priory CommIssIOner, the Hospltaller and Almoner, the Director of Ambulance, the Treasurer, Sub-Prelc:te, the Sub-Prior, the Deputy Priors, the Sword of the Order, With the Pnor and Grand Prior 's Envoy.
The Archbishop of Sydney, Dr. Mowll, gave an address. . Lieut. -General Northcott (Governor of New South 'Vales) depubsed for th e Prior, being accompanied by Lieut.-General Sir John Lavarack (Governor of Queensland) .
The Members of the Order wore black rebes with the eight-pointed Cross of St. John on their left side, and with befitting dignity the Commandery of th e Order in Australia was elevated to the status of a Priory.
ST. JOHN COUNTY COUNCILS
GUERN£EY.-Among the numerous functions held on March 6 was the inauguration of the Guernsey St. John Council by His Excellency the Lieut.-Governor Sir Philip Neame and Major-General J. E. T. Younger (Secretary of the Order). Many leading Guernsey officials were present.
OXFORDSHIRE.-The inaugural me eting of the Oxfordshire County Council was held on March 26, when Sir Miles Thomas (Chairman) welcomed th e members in the Council Chamber, Oxford. Major-General]. E. T. Younger (Secretary of· the Order) informed the members of the reasons for starting the Councils throughout th e country, and suggested certain items to which they might give attention.
Dr. C. Gardiner-Hill (Vice-Chairman and County Commissioner of the Brigade) read a leiter from the Co'unty Medical Officer of Health in which the Brigade was asked to undertake a day and night ambulance service as and from April I, I94 8 , when the health arrangements came into being. This was agreed to and details are to be worked out. During I946, over 6,600 cases were conveyed by the Brigade ambulances which trave lled over IOO,OOO miles.
PRESENTATION TO MR. D. G. MONTEITH
On the occasion of the Investiture held in the Chapter Hall, St. John's Gate, on March 6, the Sub-Prior (Lord Clarendon) took the opportunity of to Mr. D. G. Monteith a gold wnstlet watch, a list of subscribers and an envelope, as a mark of esteem and thanks for the work he had carried out during the long associations with the Order.
114
The Sub-Prior briefly referred to the many activities of Mr. Monteith and on behalf of the Order thanked him for his long and loyal services.
The presentation was witnessed by members of Chapter-General, members of the Staff, and others who received Insignia.
SOUTHERN AFRICA.
The Cape of Good Hope District, in close co-operation with the Cape Western Sub-District (Railway), undertook one of its heaviest duties on the occasion of the Royal Visit to Capt Town.
It was estimated that some 300,000 persons filled the streets along the route, which was only 2·6 miles in and, after careful preparation by the Commissioner and District Staff, the Brigade was put to the test.
The temperature on the Grand Parade abo ut midday was over 100 0 in the shade; and the absence of even the slightest breeze made conditions very trying and many collapsed and had to receive attention.
Thirty-six First Aiel Posts and Casualty Clearing Stations were established throughout the route; there being about 540 personnel on duty. Fi f teen am bu lances were on call, and these were the only vehicles allowed in the closed Town area.
In addition to members of the public, Brigade personnel undertook the care of the Police and Military personnel. aluable assislance was rendered by cout Officers and Royer Scouts, who acted as stretcher bearer ; whilst several non-European couls helped by carqing water.
The number of recorded casualties passing through the First Aid Points totalled 833; but the number of cases attended to in the street is not yet available.
The Brigade earned much praise from the Press and public for its untiring efforts. Ambulance and ursing personnel were on duty every night as thousands flocked to view the illuminations. On the "Wednesday (February 19), the barriers broke and in a few minutes 20 cases of fainting and fits were attended. The District Commandant of Police had a
special word of praise for the St. J onn personnel on this occasion.
Brigade duties continued daily and great credit is due to those men and women who upheld the high traditions and spirit of service of the Order.
Among the numerous duties undertaken were the following ;-
February 18 .-The Brigade was on duty in the streets and on the Grand Parade attending the crowds at the Civic Reception.
February 19 .-This was "Children's Day" and the Royal Party visited Simonstown, where the Nursing Divisions undertook duties in their own areas along the route, caring for the children who thronged the roads under the jurisdiction of their teachers.
F eb1'u ary 20.-Thirty-six members of the Brigade with five ambulances left Cape Town at 6 30 a.m. to augment the Divisions at Paarl and Stellenbosch. Some 60 minor cases were attended at Paarl, due to the heat. At Stellenbosch, the Queen spoke to Lady Supt. Mrs. "lTV. A. Kridge, and expressed her appreciation of the long hours that First Aiders had spent on duty since Monday morning.
Februay:y 21.-At the opening of Parliament the Brigade cared for the street-lining troops and the Guard of Honour, within the grounds of the Houses of Parliament, a duty which has been performed by them since the opening of the first Parliament in South Africa. Friday afternoon, February 21, saw the end of the week's duties when the Royal Procession proceeded down Alderley Street and King's "lay to the White Train which left for the Cape Midlands. Credit for the success of the week's work goes to all ranks for their close tion, self sacrifice, and lo yal manner ill which they carried out their duties.
The Brigade in Southern Africa has again lived up to the mottoes of the Order.
FORTHCOMING EVENTS
APRIL
18. Hospitallers' Club Dan ce, Bonnington Hotel, London.
19. Kent County Constabulary First Aid Competition, Maidstone.
24. Great vVestern Raliway Competition Finals, Porchester Hall, London.
25. London, Midland and Railway Competition Finals, Belle Vue, Manchester.
MAY
3. No. 12 Region Final Competitions, Brighton.
9. Hospitallers' Club Meeting, Bonnington Hotel, London.
9. 50th Anniversary Celebrations of the Keighley Corps.
10. 50th Anniversary Celebrations of the Barnoldswick Corps.
11. Inspection of the Sou thern Area, W.R. Yorkshire, by the Chief Commissioner, Wentworth "lTVoodhouse.
13. London, Mi.dland and Scottish Railway International COID[)(;:tition, Glasgow.
18. Dedication of Sussex Coumty Brigade Colour, Brighton.
GUERNSEY
Thursday, March 6, was a "red letter day 11 in the history of the Brigade in Guernsey. Two great events happened on a day which will go down in history not only of the Guernsey County, but also in the annals of the Brigade as a who le.
The g1'eat event was when His Excellency the Lieutenant -Governor said: " I have much pleasure and am honoured in sending this, the firs t message over Guernsey's new system of radio -controlled ambulanees- the first St. John Ambulance Brigade service in the who le of the United Kingdom to operate radio control. 11 It was at the opening of the new headqu a rters that Sir Philip Neame sent out this message from the newly opened ambulance control room to one of the amb ulan ces. Previously a new ambulance had belm dedicated by the Rev. E. L. Frossard (Vice-Dean of Guernsey); and the vehicle formally presented to the Brigade by Jurat R. H John s on behalf of the States of Guernsey.
The new headquarters were then handed over to Major-General J. E. T. Younger eSecretary of the Order), who in turn
CALLING
handed over to Asst. Brigade Secretary J. S Hannam (representin g the Chie f Commissioner) ; who before handing them over to Commissioner Dr. Fox, conveyed the congratulation<; of the Chief Commissioner to the Guernsey Di visio ns.
The Lieutenant - General presented num erous awards, including vellum votes of thanks to ex-Private Lionel Taylor for devotion to duty during the air raid on St. Peter Port, June 28, 1940 Mr. Ambrose Sherwell received the Insignia of Commander, the Rev E. L. Frossard the Insignia of Chaplain, while County Officer R. Blanchford, Corp s Surgeon Cambridge, Corps Officer R. Marquand, Supts. H. R owcliffe an d Miss G. de Garis, Amb. Officer Mrs. Marqu and and Mrs. Last received the Insignia of Serving Brother or Serving Sister. In addition, fifty-two certificates for a thousand hours duty were also presented.
The radio-controlled ambulance service is the outcome of the initiative shown by County Officer R. H. Blanchford. A permit to operate such a service was
refused in 1939 ; and neg otiations for a li cence were reopened with the Postmaster-General shortly after the Island 's liberation The cost of the installation, approximately £ 1,000, will be covered by a grant made from a bequest in the will of a wealthy islander-a legacy that cou ld not have served a better purpose or more people.
The innovation has even surpassed the expectations of Count y Officer Blanchford. It has proved of immense value in time saving, being ab le to concentrate, if necessary, all ambulances at one spot, reporting back to control, from the scene of the accident, the nature of the injuries of patients involved so that a
report can be te lep honed to hospital or doctor. The ambulance servic e in Guernsey covers the Island 's population of 40,000 and includes acc id ent and invalid transport, oxygen, blood transfusion, and the arranging a n d conveying of patients to and from the Mainland.
We extend to the Co unty of Guernsey congratulations on being the first to install such a wonderful service ; a service which is much appreciated by th e residents of the Island.
County Office r B lanchford has paid tribute to the great assistance received from the officials of the General Electric Company who were responsib le for the eq uipm ent.
TRANSPORT UNDER DIFFICULTIES
During the s now, ice, and cold spe ll ca ll from the distracted father, making an which covered the country during the urg e nt appeal for his wife to be taken to a past three mont.hs, many cases of excellent maternity home. Ambu lan ces and taxis work carried out by members of the in the neighbouring town had turned Brigade under exceptiona l circumstance down his appeal as an impossibility; have been reported.
Lowestoft, too, was reluctant to expose
Dr. A. C. Tibbits (Medical Officer o f a patie nt to such a nightmare j ourney, Health, ottinghamshire County Council) but agreed to make the attempt if it was has sent the following letter to Corps esse ntial. An hour or so late r , when the upt. F. 'Wilson ?lloulds, of the ·otting- nurse, h erself a sick woman, confirmed ham Corps. that it was an extremely urgent case, the " I have quite by chance heard of am bulance set off on the 20-mile run. another examp le of the good work done by " For the first 18 mi les the roads were your Transport Department in connection in a terrible condition; the last two, along with my maternity work. On the night a tiny lane leading from the main road, of January 6-7, one of your ambulances were in such a state that no oth er traffic conveyed a patient suffering from had made the attempt since the las t snoweclampsia from an isolated cottage at fall , and if the nurse had not stru ggled on Newstead Abbey to the ottingham to the main r oad to act as guide, it is Hospital for Women. The conditions doubtful if the ambulance would have were exceedingly difficult, the roads across arrived. As it was, it mana ge d to get Newstead Park being obliterated by snow, within 400 yards of the h ous e, and the and there was n o indication as to where patient had to be carried that distance the road actua ll y lay; in addition, th ere on a stretcher. T o turn the ambulance was a narrow wooden bridge over the round a big snowdrift had to be dug away; ravine, with steep slippery approaches, to and then the return trip started. It lasted be negotiated twice. It was solely due to until 6 a.m. the skill and zeal of the driver (Mr. "As Thurlton is well off the normal Longstaffe) that this patient reached area covered by Lowestoft, the crew had hospital, but he apparently r egard ed it as the added difficulty of being on strange coming within his day's (or night's) work! r oads in the dark, and t o make matters I should like yo u to convey to him my worse, many of the signp9sts were appreciation of his services in this and obscured by snowdrifts. At half a dozen previous difficult cases ," cr ossings, where the top s of the signposts A case reported by the Lowestoft were showi n g, th ey had to get out and D ivision also reveals difficult circum- . dig the snow away from the arms. On stances as the following story unfolds: three occasions they did some heavier " The most memorable journey was in digging, when the ambulance stuck in the early h ours of one day, when a drifts . But they delivered their patient volunteer crew of three men and one saf,el y to the maternity home-and if }"QU woman went to the r esc ue on an urg ent asked the crew about their trip they will maternity case' two miles from nowher e', tell you of the wonderful spirit of the sick on the marshes at Thurlton. midwife who struggled through the snow " It started with a midnight telephone fo r the sake of a prospective mother." , 117
Photographs (I) Control Room at the Ambulance Station'
(3) Complete view of the Aerial Mast
Control Panel for Mobile Apparatus
Micro Telephone.
(Photos by General Electric Co , Ltd.) and John W. De ar, Jun., of Guernsey.) 116
A BRIEF ACCOUNT OF THE ' HISTORY AND MODERN APPLICATION OF BLOOD TRANSFUSION
By RICHARD KING-BROWN, M.B., B.S. (Late Army Transfusion Service)
HISTORY
William Harvey, physician to St. Bartholomew 's Hospital , published his account of the theory of the circl,llation in 1628, and although accounts of transfusions had been given before this, it is doubtful whethcr any of th em were authentic.
Following Harvey's treatise, much work on was done in this country. One of the leading lights in this work was SIr Chnstopber \ l\Tren, although the practical work was carried out by his friend, Richard Lo·wer. All this experimental work was performed on animals, and accounts of it were published in 1666.
Tbe first authentic account of a transfusion performed on man was given by Jean D enys, of Montpelier, physician to King Louis XIV of France, in 1667. This account may well be given in his m¥l1 words, as published in Philosophical Transactions for July 22, 1667 :-
" On the 15 of this Moneth, we bapned upon a Youth agcd bet\\'e n 15 and 16 years, who had for above two moneths bin torment ed with a contumacious and violent fever, which obliged his Physitians to bleed him 20 times, in order to asswage the excessive heat.
" Before this disease, he was not observed to be of a lumpis h dull spirit, his memory was happy enough, and he seem ' d chearful and nimble enough in body; but since the violence of his fev er, his wit seem'd 'wholly sunk, his memory perfectly lost, and his body so heavy and drowsie that he was not fit for anything. I beheld him fall asleep as he sate at dinner, as he was eating his Breakfast, and in all occurrences where men seem most unlik ely to sleep. If he went to bed at nine of the clock in tbe Evening, he ne e ded to b e wakened several times before he could be got to ris e by nine the next morning, and pass'd the rest of the day in an incredible stupidity.
"I attributed all these to tb e great evacuations of blood, th e Pb.ysitians had b een obliged to make for saving his life, and I p erswaded myself that the little tbey had left his was extreamly incrusted by the ardour of the '... Accordingly my conjecture was confirmed by our opening one of hIS Vems, for we beheld a blood so black and tbick issue fortb that it could hardly form itself into a tbread to fall into th€ porringer. We about three ounces at :five of Clock in the morning, and at the same time we brought a Lamb, whose Carobs Artery we had prepar 'd, ou t of which we immitted into the young man's Vein, about three times as much of its Arterial blood as he had emitted into the Dish, and then having stopt the orifice of the Vein with a little bolster! is usual in other phlebotomies, we caus'd him to lie down on his B ed, expectmg the event; and as I askt him now and th en how he found himself he told me. that th.e operation h e had felt a very great heat along Arm, and smce :percClv'd hImself eased of a pain in his side, which h e had gotten the lwenmg by down a pair of stairs of t en steps; about ten .of the Glock was mmded to nse, and bemg I observed him cheerful e nough, I. :Qot oppose :t; and for rest of the day, he spent it with much more hvelmess than ordmary; eat hIS Meals very well, and shewed a clear and smiling C0Yntenance .... He fat visibly, an.d in brief, is a subject of amazement to all those that know hIm, and dwell WIth him."
Shortly after this, other Frenchmen following Yp Denys' wOFk first noticed severe reactIOns to transfusions and this was not surprising, in the light of subsequent knowledge. . .
!3a.muel Pepys in 1668, in his Diary, gives further accounts of transfusion s
done on human beings, one poor man receiving twenty shillings for his sufferings (as, no doubt, they were in those days).
All these early experiments were don e from animal to man, often with dire results, so it is not odd that Blood Transfusion fell into disrepute, where it r emained for over 100 years.
Not until about 1 820 were the first buman to human transfusions performed by Jam es Blundell, lecturer in physiology and midwifery at St. Thomas' and Guy's Hospitals. The results were very poor, but this was not surprising, as most of his patients were either moribund or dead!
One of th e chief difficulties at this time was that th e blood coagulated rapidly, and several mechanical m ethods were tried with variable r es ults to prevent this.
In 1857, Higgin son invented his syringe for blood transfusion, and gave several successful tran sfusions. His syringe has now found other uses!
About 1875, blood transfusion again fell into disrepute and other solutions, such as normal saline (salt solution) and milk were tried.
At last, in 1907, the four blood groups were described by Jansky and confirmed, in 1 9 10, by Moss in America. In I9I4, Lewisohn, also in America, first used sodium citrate as an anti-coagulant and this, plus the knowledge of th e four blood groups, put blood transfusion on a firm scientific basis.
Blood transfusi on was not much us e d in the First World War, until the last two years, wben it was popularized by Amencan doctors and used witb considerable success in tb e last two years of the war. From then onwards steady progress bas been made until at the present day it is a vast and complicated subject.
PHYSIOLOGY
Blood can b e divided into two main parts, fluid and corpuscular.
The fluid part, known as plasma, r epresents 55 per cent of the total volume, and the corpuscular part, consisting of wbite and red corpuscles, constitutes 45 per cent. There are far more red than white corpuscles, and it is mainly with these that vve are concerned. .
The average volume of blood may be taken as one pint per stone body weigh t, giving a volume of 10- 12 pints in the average man.
BLOOD GROUPS
Th ese are four in numb er, named I, 2, 3, 4, or AB, A, B, 0, the numbers or letters r eferring to the red corp u scles. The test for th ese is fairly simple. In blood transfusion tb e important thing to remember is that the blood corpuscles of the donor shall not be agglutinated by the plasma of the recipient. By agglutination, we mean clumping together of cells into fairly large masses which would block the small blood vessels of the patient, often causing death. By means of the following chart, it is possible to forecast the reaction between given bloods:-
DONORS
Crosses represe nt the occurrence of agglutination, and therefore unsuitability for transfusion.
From the above it may be seen that group AB Gan receiive blood from any other .group, and is known as the universal recipient, and group 0 may be given to anyone, and is therefore known as the universal donor.
In Britain the n.umber in the various gToupS is :-
These percentages vary with race, Indians, for instance, having nearly 20 per cent :8, and only 3S-40 per cent O. Groups never vary throughout life ...
In blood transfusion it is preferable to give blood of the same group, or faIlmg that, blood of group 0, the universal donor.
Other substances than blood may be given by transfuslOn, e.g. :-
Plasma.
Normal saline (I per cent solution of salt).
Glucose saline (S per cent solution of salt with S per cent glucose).
Hypertonic saline (5 p er cent solution of salt).
Others.
Plasma may be given for wound shock, and following burns.
Saline (normal) and glucose saline may b e given when the patient is in coma and unable to drink or to replace fluids lost by diarrhcea or vomiting.
Hypertonic saline is often used in severe diarrhcea, such as cholera.
I NDICATIONS FOR TRA TSFUS IO XS
1. Acute hcemorrhage, such as may follow injury or childbirth.
2. Conditions of ancemia, i.e. lack of red blood corpuscles.
3· Septic conditions when it is used to strengthen the pati ent, and help to provide some immunity to the infection.
4· Plasma may b e given following acute hcemorrhage, shock from wounds, or burns.
TAKING OF BLOOD
Patients must first be grouped into one of the four groups. This necessitates only a small prick; in the finger or ear, and the taking of one drop of blood.
The bleed.ing takes only S-IO minutes, and is performed by inserting a needle mto a usually at the and the blood flows through this, then through a pIece of rubb er tubmg mto the blood bottle, which con tains about three ounces of sodium citrate solution. A local ancesthetic is used in the arm .to pain ,?eing caused by the bleeding needle.
Blood IS stored m a refrIgerator at a t emperature of 39°-42° Fahrenheit, and lasts up to 4-S weeks. Plasma on the other hand, made by filtering off the red blood corpuscles from .the blood, can be stored for six months to a year in a cool, dry place, dnedylasma for anything up to S or 10 years. This latt er must be reconstItuted WIth normal saline before use.
To GIVE A TRANSFUSION
The. patient first of all be grouped. Then an appropriate bottle of blood IS the group, or group 0, and cross matching is carried out. This consIsts of some :plasma from the patient and adding a drop ?f .blood the bottle to It, and If no agglutination occurs in IS-20 minutes, It IS conSIdered safe to give.
The be warmed slightly at rO tl m temperature before being used. Any vem IS sUItable, although a vein in the forearm or lower leg is selected. If, for some. no vem can be found, it may be given into the marro:,", of a bone. ThIS. IS done in children, in whom it is technically very dlfficult to use a vem. A clIp is then put on the tubing connecting the bottle to the needle, to control the rate of flow E g in acute h= h 't' 11 d . .. ""morr age, 1 IS a owe 120
to run in fast, whilst in an ance1l1.ia, it must b e dripped in very slowly. A small glass drip chamber is inserted into the rubber tubing, so that the rate of flow may be seen and adjusted accordingly.
REACTIONS
TO TRANSFUSIO NS
I. Simple febrile reaction, shown by a rise in temperature of the patien t, and sometimes accompanied by a shivering attack. This is not serious.
2. A completely incompatible transfusion due to blood of a wrong group. This is shown by severe backache, vomiting, a shivering attack, and a rise in temperature. Later the kidneys may become blocked and stop functioning, and death may ensue. With careful grouping and cross matching, this should n eve r occur
3· Transference of disease, e.g malaria, infective jaundice, etc This is avoided by not taking blood from infected donors.
4· Overloading of the circulation. If too much fluid is given into a vein too rapidly, the heart may not be able to cope with the extra work entai led, and the circulation becomes embarrassed.
ILLUSTRATIVE CASES OF TRANSFUSIONS
I. Blood TrallsJusion.-A soldier, wounded in France, had a piece of metal lodged deep in his armpit. On operation it was found to be lodged right in his axillal')- artery. R emoval of this caused very severe bleeding, which was controlled only with difficulty. It was found necessary to give this man eight pints of blood during his operation, and shortly afterwards to make good his loss. The man made a good recovery, even though it had been necessary to tie off his artery to stop the bleeding.
2. Plasma TransJusion.-A soldier had been extensively burnt by a petrol explosion. The raw burnt areas were exuding plasma, 'as is always the case, and for him to live, it was necessary to replace this with an equal volume of plasma given into a vein. This meant giving him about IS pints in the course of 48 hours.
3· Saline Transfusion.-A sample case may be taken of an Indian soldier suffering from a very severe dysentry with enormous loss of fluid from his bowel. With this loss of fluid he was also losing a large quantity of salt. It was necessary first of all to replace the salt, which was done by giving him one pint of hypertonic saline (S per cent salt solution), followed by many pints of normal and glucose saline solutions. This was continued until the severe diarrhcea and collapse had stopped, and it required 20 or more pints of saline, given at the rate of one bottle every two hours or so.
These cases illustrate three very different types of transfusions, and show the diversity of conditions in which transfusion may be required.
SUMMARY
Blood transfusion has not stopped with the end of the War . It is being used more and more with increasing knowledge and safety. It finds its main uses now in :-
I. Accidents (road, mine, an.d industrial).
2. Childbirth (following hcemorrhage of the mother, and also in certain diseases of the newborn child).
3. Medical conditions, such as:-
(i) Bleeding from ulcers of the stomach.
(ii) Bleeding from tuberculous disease of the lungs.
(iii) The various ancemias.
The use of blood is becoming more and more widespread, and the need for donors more and more urgent, so if you have never given a pint of blood, why not give one now ?
INFECTION IN WOUNDS
By Dr. J ETHRO GOUGH
(Synops is of lecture g iven un d e11 the Fi rst Aid in Mines Campaign , organ ized by the P riory for Wales)
So urce s of I nfection.-Infection may occur at the time of injury from dirt, soiled clothing, or the skin. Such infection may include tetanus, gas gangrene, and staphylococci from the skin. The common infections which produce pus occur most commonly after the injury , directly or indirectly, from the per ons treating the case. Streptococci cap a b le of producing serious wound infections are present in the throat of IO per cent of normal people; staphylococci are present in the nose of 40 per cent of normal people.
Prevention of I nfect ion .-Tetanus can be prevented by giving anti-tetanic serum immediately after injury. vVhere there is very grave risk, as in war wounds, immunization can be carried out. The risk of gas gangrene can be diminished by speedy surgical treatment of the wound with the removal of all damaged tissues, especially damaged muscle and by the use of su lp honamides penicillin, and anti-gas gangrene serum The risk of streptococca l and lococcal infection can b e reduced b y minimizing inspection of the wound and by covering it as quickly as possible with a sterile dressing. The subsequent treatment of the wound , even if it is a minor one suitable for handling in an room, should b e by the n on-touch techniqu e. In this, all concerned, the patient, wear ad e qu a t e masks; th e person carryi ng ou t th e dressmg washes and dn es the hand s and handles all th e materials used in the with f?rceps , and does not touch directl y anything which will come mto contact WIth the wo und.
Contamination fro m D ust. -In hospital s and rooms where casualties are treated, a of infection is dust from the floor. Dressings should not be carr:e.d out unbl at least an h our after sweeping when the dust will have settled. OIling of floors and blankets minimizes dust .
Antiseptics.-There is an increasing tendency to use powders for first aid and treatment ?f wounds in place of solutions. The most popular are sulrhonamIdes, proflavme, and p enicillin. Mixtures of sulphonam id e and proflavme may be us e d and penicillin powder is used mixed with sulphonamid e It must be that sulphonamides may produce a rash in some persons, espeCIally If used over a lon g p eriod.
SOUTHERN AREA COMPETITIONS
The competitions to decide which teams from Cornwall and Devonshire shall. go forward to the Regional CompetItIOns, were held at Plymouth on March 22. Arrangements were in th e hands of County Supt. Mrs. R. Balsdon whilst Ccmnty Surgeon C. R. Croft supervised thA tests. The results were :_
Ambula.oce: 1st (Smerdon Shield)Carmenellis and Stithians (Cornwall); 2nd, Plymouth Co-operative.
Nursing: 1st. (Lennard Cup), Plymouth Co-operatIve; 2nd, Paignton. The ".v osper Cup" (Bed making) was also gamed by the Plymouth Co-operative Nursing team.
The trophies were presented by the Lady Mayoress of Plymouth (Mrs. W. Harry Taylor) who was introduced by County Commissioner C. S. C. Prance.
POLICE AMB'ULANCE NEWS
METROPOLITAN
" M" Division.-The annual competitIon for the" Dalto n-Matthew" Cup was held on March 10, when A sst Commissioner Dalton (part donor of the Cup) the tr ophy to Southwark, who gamed first place from Rotherhithe.
Fros and W. P. S. Smith (Kenlll?gton "Road) gained the "Cecil BIgwood Cup for the pairs competition. Supt. Robertson expressed thanks to the judges and welcomed the guests. Those present included Commandant Matthews (part donor of the Cup), District Comman.der Sanders, and many other Police offiCIals. The judges were Dr. E. S. Abraham and Supt. Bandy (S.J.A.B.).
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PRACTICAL experi ence both in civi l and military hospitals throws in great relief the need for a true physi ological tonic. This is interpreted in day -te -day pra ctice as the necessity for a liq u id food which completely meets ev ery metabolic n eed , is readily a ccepted by the patient and is immedi atel y assi milated.
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THE 'Heal ing Hand'
HEADQ UA RTER NOTES
All members of the Bri gade retu rning from H.M. Forces, Joint War Organ ization, and J oint Committee Activities should make themselves conve r san t with B.O. 788, issued with the February Brigade Orders.
No.1 (P RI NCE OF WA L ES' S) DI STRICT
On March 12, Viscountess Moutltbatten (Supt.-in-Chief) carried out her l ast Brigade function before accompanying her h u sband to India when she officia lly opened the new headquarters of the No. 1 District. The Commissioner, Major A. C. vVhite Knox, welcomed Lady Mountbatten, who was accompanied by Lady Dunbar-Nasmit.h (Deputy Supt.-in -Chief), and referred lo the fact that the District had been honou red to have her as their President.
Lady Mounlbatten was tremendo u sly happy that her last function before going to India was t.he opening of No .1 Distri ct Headquarters. She had been happy in her association with the District and recalled that when she first joined the Brigade it was as a member of the No.9 ursing Divis ion. The number of duties carried out by the District \vas amazing;
but H ead quart er s n ever called upon its perso nn el in va in. She w as sad that she was leavin g her N urs in g Divisions but in L ady D u nb a r- Nasmit h she had an excellent D ep u ty She m a de r ef erence to the loss su stained by t h e District b y the death of Capt. Goodley ; a nd extend ed to Maj or VVhite K n ox a n d No. 1 District a ll best wishes fo r the fu t u r e.
District Supt. Miss Workman express ed thanks to Lady Mo u ntbatt en fo r sp a rin g a little 0f her valu ab le time t o open th e Headqu arters and w ish ed h er a n d her h u sband every su ccess in t h eir future undertaking.
Deputy Commission er D . L owso n, on behalf of a ll present , proposed thanks to Mrs. \iVl1.ite Knox fo r the h osp it ality extended; and took the oppo rtunit y of warmly welcoming the n ew Commission er and assured him of the loyal su p p ort of all perso n nel.
Those present included B r i gadier W. B G Barne (Secretary-Gen er a l of the Order) , Sir J ames Sleeman (Cl?-ief Commiss ioner, B r igad e Overseas) , MaJorGeneral J. E T. Yo u nger (Sec r etary o f the Order), Major-Ge n er a l F. V. B Witts (Asst. Director of Ambula nce) , Capt. A. Cahusac (Chief Secret a r y of the Association), Miss Cunard (Chief Officer
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cl ear s up MAN Y SERIOUS LEG TROUB
The Viscountess Burma at the op ening of No ..1 (prince of Wales's) District Headquarters. Those shown, from left, Asst COIDnusslOaers Capt R V. Steele, Dr. E S Abraham, Capt. G. R H. Wr!lngbam, Dr. G. M Steker, Commissioner Majer A. C. WID ite Knox, Col. Su Jo1m Sleeman (ChIef Brigade Overseas), Viscountess Mountbatten of Burma, Deputy Alderman D. C F. Lowson, District Supt. Miss Workma,?-, Asst. Su Geerge Abbiss, Lady Dunbar- Nasmith (Dep\lty Supermtendent-m-ChIef), Asst Comm issioner G P Hart 125
Nursing Cadets), members of the Brigade Headquarters Staff and Area Assistant Commissioners and District Headquarter Staff
Tribute w as paid to t he work undertaken by Mrs. Butanowich (Commissioner ' s Secretary) in making the premises ready. Amb Officer Miss White Knox presented Lady Mountbatten with a spray of orchids.
No. 33 (Bermondsey) Division.-A
Massed Band Concert was given on March 13; two sil v er bands and on e accordion band pro viding the mus ic Commissioner Major A. C White Kn ox introduced the Mayor (Councillor F A Po w ell), who promised full supPQrt for
tendent of t h e Division . Dr. Setna als o h a nd e d him a p er so n a l g ift of a ciga rett e case Corps Office r Green , w h o had been a membe r of t h e divisio n fo r 20 y ea r s, expressed t h a nk s , and stat
he was l eavin
of A mb Office r C A. L iffo
Staff Sergt A V Gib b ons said that as" fa t h e r of th e Di visio n he was pro u d to t hink t h a t three of their members in the p a s t few y ears h a d b ee n chose n for d u ty a t H eadqu a rters First, Mr. Cla ri dge , the n Mr. Allu m , a n d n ow Mr. Gree n ; qui te a n a ch ievement for a re lative ly small di vis io n L AN CASH IRE DISTRICT
the Brigade in its g ood work. T he second of the ann u a l D is trict No. 37 (G. W.R. and Paddington) N ursin g Competition s was he ld a t P r es to n Division.-A "Re-union" Dinner an d on March 15. Those present incl u ded Social was held recently at which ninet y - Dis t r ict Su pt. M iss M. R. Moore, Co un ty four members and fri ends attended . The Surgeon D ora E. Wheeler, District Office rs guests included President Sir H. V Miss 1. M. Sutcliffe, Miss J. Eccl es , Mrs. K enyon, Distdct Officer (R ) McBride A C. Owen, Miss K. Lamb, Miss H . M and Mrs McBrid e , Dis trict Officer Dun- Smit h , and Mrs. G. M. Normanton. ford , Mr. R Burrou gh (Secretary , Lond o n T he j udges were Dr. Dori - Derbyshire District, G W.R Ambulance Centre) , and (team), D r. Mu r iel Shaw (ora l ), Dr. Messrs . R Hodges a nd C. Barnes (Hon . K athleen E. Thompso n , and District Auditors). Dancing followed, at w hich Ca d et Officer Mrs. Bay ley (individ u a l ) Amb. Officer Smith (who w a s r esponsible The r esults were: 1st (1 ursing Cha lfor the arrangements) acted as M .C. l en ge Sh ie ld), Blackpoo l (2); 2 nd (Bessie No. 71 (Edmonton) Division.-At th e T rim ble Cu p), Blackpoo l (1). I n d iv idu a l : 32nd Annuall'vIeeting, Supt. S. ]. Richards 1st (L ytham Vase), Mrs. Rothwe ll (Todpresided in the absence of Pre sident Ald. m ord en ); 2nd (Lancashire Cu p), M iss J. Reid It was reported that thirty -fi ve Fearn side (Blackpool ). members were still serving w ith H .M. Th e Mayor and Mayoress of Presto n Forces, and that during las t y ear 1,229 (Ald erm a n and Mrs. Beckett) presented duties had been covered and 229 case s the trop h ies, and in propos ing a vote o f attended. The financial p osition w a s th a n ks t o t h em District Officer M iss Smit h satisfactory Cadet Offic er Strange off e r ed sympathy to a ll citizen s of P r es t on reported on the activities of t h e Cad et on the loss of the Town Hall, which ha d Div ision. The Chairman referred to the b ee n p a rti a lly dest royed b y fi r e t hat fact that Mr. T. West had won the Rotary m ornin g. Cup in 1939, but o w ing to the fact th a t Atherton -At t he a nnu a l party of the he had been away in the RN Sick Berth Athert on Amb ula n ce an d N u rsin g during the w ar years, it had not been Di vis ion s , Pres ide n t Co un cillo r C. Fle t c h er possible to present him with a miniature introd u ced t he n ew Commissio n er, Ma j o r cup This Supt. Richards had ml!lch E S. Burt-Ha milt o n , a nd D is trict O ffice r pleasure in now d o ing ; and a simila r Miss K. Lamb t o t he p a rt y. N ursin g awa rd was presented t o Mr. A. Andrews Vice-president Mrs. F . Wardl ey w a s w ho had gained the cup in 1945. Tha nks presen te d wit h a fo un ta in pe n a n d p en c il were extended to the Secretary, the as a mark of ap p r ec iatio n fo r her s erv ic e Treasurer, the Duty Officer, and all to the Divisio n s. for their loyal support and help Radcliffe.-Two n ew m e m o rial table ts dunng the past year. were recently un ve ile d at the H e adquarters No. 140 Post Office) Division.- of. Radcliffe Ambulan ce and Nursing
The first DIVISIOnal Social and Dance DIVISIOns . The fir s t is t o the late Dr. was held on March 8, when Slilpt. A. W. Isaac Flack, Surge o n to the Di v isio n s for Church welcomed the Visitors and ex- many years, and the l a te Gilbert Entwistle, pressed the hope that this event would be Superintendent from 1898 until his death followed by others a few years ago. The second is to t h e No. 135 (Harlesden) Division.-A t an memory of Arn o ld J on es and William mformal Dmner held recently, Div Ashton, wh o paid th e supreme sacrifice
Surgeon H M. SetJ?-a presented Corps during the Seco nd W o rld War. The Officer S. ]. Green WIth a chromium and unveiling c er e m onies were carried out by glass tray as a token of esteem and Mrs. S A. Jones and Mrs. Ashton and appreciation of his services whilst Supe rin- Supt. Miss E. A. Wilkinson - SRpt T 126
J one s p re sid e d a nd r eferred t o each of th e m e mbers.
Nelson. - During the c ourse of a social e vening, 50 yea r s ' lo ya l s ervice t o the Nel so n Co rp s b y Co rp s Supt. H B a nnis t e r w a s publicl y r ecog ni zed b y a prese nt at ion to him an d M rs. Banni st e r b y Pre sid ent Sir J a m es A it k en T he p rese n tat io n c o mprised a r a di o se t s ur mo un te d o n a small tab le, a r eading lamp, a n d mo n etary g ift. M r Banni s t er h ad bee n Corps S u pe rinte n de nt s ince 19 13; a n d atte n ded the W indsor Great Pa r k Review in 19 12 B u t for his lack of stature he wou ld have served in the Sout.h African War; but he d id attend the Diamo n d Jubilee of Q u ee n V ictoria. Sir J ames said that Mr. Bannister's record was wonderfu l and few co ul d equal it. It was just 5 1 yea r s ago since 1\ 1r. Bannister gained his first aid certificate and he received the Service Meda l in 19 12. Mr. Bannister r ep l ied w it h many thanks to the members and spoke at length of the many incidents and memorable occasions in the course of his lo n g sen' ice.
CO NTY OF BE R KSH IR E
w ere c alled b y the B r a dfield R ur a l Dis trict Council to evacu a te thirt y famili e s from the camp. These w ere a ccommodated in the B r i gad e H e adqu art ers and w ere vi s ite d every da y. Twe l v e families r eceived F irs t Aid; and S upt. Miss Co rd e r oy h as recei ve d a lett er of thanks fro m t h e Cou n c il.
Ascot. -Recentl y m em b ers of th e Asco t Nurs in g a n d A mbula n ce a n d N ursing Cade t D ivisio n s and Se ctio n o f the Am bula n ce Di visio n h e ld a p a rty at w hic h t h e gu es t of h o n o ur w a s Miss Watso n (Staff Officer to Supt. -in-Chief ). Others present included County Supt. the H on. Mrs. Leslie Ga m age , Co unty Cadet Officer Mrs . Mo n tague -Puckle, County Officer M iss Gi b b ins , Div Surge on Maycock, and Mrs. Cocy, Head Mistre ss of Ascot Heath Gir ls' Schoo l. R ea din g Ce nt r al.-The Central N ursing D iv isio n rece n t ly he ld its a nnu a l s o cial evening at H eadquarters
R ea din g P os t Offi ce - The 19 4 7 competition for the" Gamage Cup" too k t he form of a First Aid and H ome N ur sing quiz, which was arranged and c ondu cted by County Officer Miss Gibb ins, ass iste d During the recent Roods in the County by Co rps Su pt. Miss Sud ul. Two t e ams of Berkshire Lhe Brigade were very act ive. tied for first p lace ; and fi n a ll y t hat le d County Commissioner C. A. Poole placed by Ho n Sergt. Miss Wyatt was placed bu ildings, per onnel, and vehicles at the first. disposal of the County and Borough Wi n ds or.-At the annual B r igade Dan ee A u thorities who made full use of them. the '[ayor, who was accompanied b y the At Wind s or, rescue work was carried Mayoress, thanked those prese n t for out by members of the Royal Windso r s u pport given to the Brigade. Division from early morning to late at W oolhamp t o n a n d Brimpton.- Dr. D . n ight, with personnel standing by during Munro Ashman pres ided at t h e a nnu a l the night. An Army" Duck" was p laced meeting and welcomed the n ew p r esident, at Brigade disposa l to dea l with stretcher Mr. W. E. McI lroy , who said b e was ver y cases; and many were conveyed from p leased to be associated 'with the Di vi si on s h ou ses. Supt. Simonds reported t h at During the meeting a fo untain pe n was every member gave his or her best an d prese n ted to Dr. Munro Ashman o n beha lf great p r aise has been received from the of the mem b ers in app r e cia tio n of his Loca l A u thorities Members have a lso ser vices. ass isted with the feeding and clothin g of t hose evac u ated. Two ambu la n ces were se n t by the Brackne ll Di visio n to ass is t wit h the evac u at io n of pati e nts fro m th e Kin g Edwa rd V II H ospit al ; w hilst M a ide n head D i v is i o n s a lso p rovided a n a mbul a n ce and perso nn el to a ss i st in this w o rk.
In Bracknell t h e Briga de we re calle d upon the r e m ove p a ti e nts fr o m Winds o r P a rk, Sunning dale, A s c o t, Ch avey D o wn, B racknell, Cro wthorne, and
CO UN T Y OF BEDFORD
Wardown Nursing Di vision.-A 4 t h b irt h da y w a s rece ntly cel e b rat e d b y this Di v i sio n, wh en h u s b a n ds a nd fri en d s , and m em b e rs o f the Ambul a n ce Division, joined in gam es and danc e s. Supts. Steve ns a nd Mrs . Stevens presente d award s du r in g the functi o n
COUNTY OF BIRMINGHAM
Supts. G r een and Mrs. Green mu c h Witton.-At a re c ent party of the " B " appreciate the fine response made by Di v ision, a prese ntation w a s made to th eir m e mber s. Mr. and Mrs . Lloyd . Mr. Lloyd . was
Supt. Fisher of Didcot, whose division S uperintendent of the Division for a d e als wit h a g reat numb er of stretcher numb er of years a nd has recently been patients in conne ction with the Radcliffe promoted to Corps Officer in the BirInfirm a ry and other hospitals in the mingham II A "Corps. A n e st of table s District, reported that he was able to deal from th.e members as a tok en of appreciawith all the cases e ntrusted to him. tion was handed to them by Amb. Officer od! t h e Theale Nl,.u sing Divisi on A E. Greell with best wishes f or th e 1Z7
future. Mr. Lloyd presented warrant of appointment to Amb Officer H F. Hearnshaw, who is now officer-in-charge ; whilst vice-presiQent W. H. Stanton presen ted awards.
COUNTY OF BUCKINGHAM
Princes Rishorough.-The new ambulance was dedicated by the Rev. E. Ellis Roberts (Rector of Monks Risborough), who is a vo lunteer driver, in the Church Square after a short service conducted by the Rev. J. Go wer Williams (Rector of Princes Risborough) assisted by the Rev E. W. S Pipe (Rector of Saunderton). Owing to the weather , County Commissioner Major DarvilSmith was unable to be present.
COUNTY OF CORNWALL
The finals of the County Ambulance and Nursing Competitions were h eld at Redruth on March 8. The r esults were :Ambulance: 1st, Carnmenellis and Stithians; 2nd, R ed ruth.
Nursing: 1st, Falmouth; 2nd, Redruth. ' The Cup for Bedmaking was award ed to the R edruth Nursing Division and the Cup for Individual wor k to Redruth Ambulance Division.
The Lord-Lieutenant of Cornwall (Lt.Col. E. H. W. Bolitho), who is also County President, presented the trophi es and d escribed the mo veme nt as "an organization which works for everybody and everywhere " H e also remarked on the excellent team spirit displayed that day.
County Co mmissioner Lt.-Col. W. Blackwood presided and congratulated the '\vinning teams.
The judges were County R. H. Hadfield and Asst. Commissioner W. W Johnst on (team), County Commissioner Lt.-Col. Blackwood (individuals), and Miss S. L. Lu xto n (Liskeard) officiated in the bed making tests.
Penzance.-At a "welcome home" dinner held by the Penzance Division, Vice-President W J. Hichens, proposing the toast to the Division, said: "I believe that such a ssociations as this form the selid fo undation on which our community is b ased. England in general owes more than is reali zed to the voluntary organizations ." The Division was fortunate in hav in g a man as vigorous a s Supt. Maycock; and Mr. Hichens paid tribute to the wo rk done by Amb. Officers C. H. Sheppard and W . 1. Wood. Supt. Maycock, in reply, referred to the increasing number of calls made on the ambulance service. Dr. Hadfield (County Surgeon) paid tribute to the work of Supt. Cooper during the war years. An appeal was made to all returning members to rej oin the Division.
COUNTY OF DERBY
Chesterfield.- The Chesterfield T ube Co.'s Division r ecently entertained the Tubes, L td., Division and friends to a competition and social. Supt. "White welcomed the visitors and after lunch both Divisions were inspected by Corps Supt. J. A. Simpson (Birmingham). A competition for individual and team tests followe d, being set by Cadet Supt Hibb er (Staveley Corps) assisted by Cadet Officers Turner and Mansell. Chesterfield gaine d 383 marks, being 10 in front of Tubes, Ltd. After tea had been served a socia l evening was spent by some 150 members and friends.
COUNTY OF DORSET
Poole.-The annual social of the Poole Corps was held in the Oddfe llows' Hall ; when members of the Nursing Corps also attended. County Commissioner Dr. R. V. S. Cooper presented awards which inclu ded 2nd Service Bar to Medal, County Officer E. Paddock; 1st. 'ervice Medal to Corps Officer J. L. Ro berts ; Service Medals to Corps Supt. F. C. Bryant, Corpl. Smith (Parkstone), Pte . H. White (Hamworthy), Pte. l\Iitchell (Par kstone) . Dr. Cooper (who was accompanied by County Supt. Mrs. Cooper) was introduced by Corps Officer L. Fowles, and he appealed to all members to strengthen th eir ranks. Corps Surgeon R. J. 1\Iaule Horne voiced thanks to the County Commission er and Mrs. Cooper for their attendance
COUNTY OF LEICESTE
R
Melton Mowhray.-A satisfactory report was g iven at the annual meeting of the Melton Mowbray Nursing Division and Waltham Section at which County Offic er Miss L. Burns-Hartopp stressed the need for n ew members. The Medical Comforts Depot was firm ly established, duties being sh ared with B.R.C.S person n el. During the year, 42 cases had been treated, with a furth er 15 by the Waltham Section. Amb. Sisters Mrs. Jackso n a nd Mrs. O'D ay had completed 666 hours of duty at the hospital. After the meeting, games and dances were held. Those present included Div. Surgeon 'Woods, Supt. Mrs. M. Watson, V ice -president Mrs. T. R. Stockdale, and other divisional officers.
COUNTY OF LINCOLN
Brumhy.-On March 8 the Brumby Ambulance Div ision e nt ertained members of the Gainsborough Div ision to InterDivisional Games. Billiards , chess, dominoes, draughts, darts, etc., were iIiJ.dulged in, and the result of all the match es was a draw. Amb. Officer B. C. Wilson thanked the Brumby Division for l28
their hospitality and hoped the event wou ld become an annual one. These functions create a feeling of good fe llowship between the members. Amb Officer P. Holla nd, in repl y , said it was a p leasure to entertain their Gain s b oro ugh friends, and expresse d thanks to those who had assisted , especially 1\1rs . C. A. Wallis , who had g iven an iced cake for a raffie.
The Brumby Division has recently he ld lectur es on " Industrial D ermat iti s" and "\Vound Shock" whic h were given by Div. Sur geon F. Stan ford a nd Dr. O. Neil.
PLYMOUTH, S.W. DEVO N, AND E. CORNWALL
The ann u a l County Competitio n s were held on March 8, when Dr. 1\1. C. Cooper ju dged the team test and Dr. J. A. Nixon 1\1 orr is the Individual tests. 1\1rs. Ellis, .R. ., judged thc Bedmaking.
The results were :-
A mbulallce : 1st (Jloundiscornbe Cup) , Plymouth Co-operali\,c Division; 2nd (Coronation Cup), Plymouth Reinforcing Division. The" \\ innicotL " Cup for the highest score in the Individual Tests was gain cd by Plymouth Co-opcrati\'c; whilst Plymouth Hcinforcing gained the " Pengelly" up for Lhe highcst marks in the team Lcst.
Nuysing : 1st (Queen ie Ball Trophy), Plymouth o-operative Tur sin g Di vision; 2nd (Caroline 13eckly Cup), St. Boniface ur sing Division. The" Dorothy \ iVard " Cup for Bedmaking and the" Co r onation" Rose BO'wl for the highest score in the Individual tests were both won by St. Boniface. The trophies were presented by Rear Admiral R. S. G. N icholso n (Admiral Su pt. of Devonport Dockyard) who was introduced by County Commissioner C. C. })rance.
Asst. Commissioner Co l. G. Thomson, County Officer Mrs. Modley, and Co unty Cadet Officer Mrs . \ i\Tood were ju dges for the uniforms ; whilst Co unty Supt. Mrs. R . Balsdon was re sponsible for the arran gem ents.
Ta vistock.-The a nnu a l socia l and dance of the Tavistock Ambulance and Nursing Divisions was h eld on March 19, when Co unty Commissioner Prance presented a fountain p en and illuminated address to Lt.- Co l. A. H . O. Young on his retirement from the position of Divisional Surgeon after 20 years' service. The Commissioner a lso pres ented him with the Insignia of Serving Brother of the Order; and a bouquet to Mrs. Young.
Mr. F. G. Grigsby (Chairman of the Association) presided, being supported by Div. Surgeon T. Gillies, Supts. H. G. S t ock bridge, and Mrs. Smith.
COUNTY OF SURREY
The annual County Competitions were held at Reigate on March 22, at which Co unty President the Countess of Lindsay presented the trophies to the successful teams.
The results were:
Ambu lan ce : 1st (O n slow Cup ), Reigate; 2nd (Martin Williamso n Cu p) , Redhill. Nursi ng: 1st (O n slow Cup ), Guildford No. 1; 2nd (Ethel Deane Cup ), Redhill and Reigate.
Cadets , J unior A 1st (Harris Cup), N utfi eld; 2nd (Blades Cup), Merstham.
J u n ior Nursi ng: 1st (B lades Cup), So uth Park; 2nd, Godst one.
South Park Cadets a lso wo n the Christian and Nicholas Cup for the best Cadet T eam in the County ; Nu tfield Cadets won the" Mary Long" Cup for th e best Eastern Area team; and the R edhill and Reigate Student Division will represent the Co un ty in the Regional Senior Nursing Cadet Section
Tests were prepared by County Surgeon Capt. G. O. M. Dicken so n and Corps Surgeon K Watson (Redhill).
Those present inclu ded County Commissioner W. Geo. Pape and County Supt. Mrs. Heald; whilst Asst. Commission er J. P. Flavin was Competition Secretary.
COUNTY OF SUSSEX
Worthing was th e venue of the Co unty Competitions held on March 22, when s ome 40 teams competed in a ll sectio n s.
The res ults were :-
Ambulance: 1st (Gentles Cup), Horsham; 2nd, Littlehampton.
Nursing: 1st (Gentles Cup) , Roedean; 2nd, Worthin g
S enior Cadets, Ambu l ance : 1st (Jarvis Cup), Horsham; 2nd, Southwick.
Nursing: 1st (Bessborough Cup), Southwick; ·2nd, Brighton.
J unior Cad ets , Ambulance : 1st (Hinkley Cup), Southwick; 2nd, Chichester.
Nu,rsing : 1st (B es sborough Cup), Chichester; 2nd, Brighton.
R oedean Nursing Div ision also gained the Bedmaking Cup and Southwick Junior Ambulance Cadets the" Trotter" Cup for the best \iVest Sussex Team. County Commissioner D. Bryce announced the results and also that Southwick Ambulance Cadets and Brighton Nursing Cadets had gained the Efficiency Cups for the year.
The Mayoress of Worthing presented the trophies and also a Grand Prior's Cadet Badge to Cadet CorpI. Wendy Terrell (Southwick). The Mayor said that he looked upon the Brigade as a valuable asset to the town and wished it every success in the future. Asst . Commissioner 129
F. A. Trott and County Officer W. E. J upp were the Competition Secretaries.
Brighton.-On March 8 the Brighton Corps held a very successful Spring Fayre in the Corn Exchange. It was officially opened by the Deputy Mayor (CounGilior W. Clout) who was accompanied by Mrs. Clout; whilst others present included the Deputy Mayor of Hove (Alderman A. H. Clarke) and President Alderman F. G. BeaI. Great credit is due to Corps Vice-president Mrs. Stuttaford and her Social Committee for the most excellent arrangements. Stalls, numbering 15, were attractively arranged and business was very brisk during the day. Pupils of the Dodo J ayes School of Dancing gave displays in the Pavilion Theatre; whilst there was a display stand of Medical Comforts, and Road " Safety" under the superVISIOn of the Bnghton Police.
Corps Surgeon and Supt. F. H. Stuttaford supervised much of the workings; and all members played their part in the proceedings.
It is anticipated that nearly £300 will be added to the Funds as the result of the Fayre, which is an annual event.
The annual Corps Meeting was held on March 19, when Asst. Commissioner Trotter presided. Public duties had increased and 3,880 had been coveTed. Two Beach Huts were manned throughout the season; whilst Nursing and Cadet N u rSi?g personnel ga ve 1,742 hours, carrymg out 433 hospital duties. Transport duties numbered 390, whilst cases treated 608. Twenty-seven courses Qf illstruction in all subjects were held. The ambulances received 419 calls (11,218 miles) and the Medical Comforts Depot is in operation.
Roedean.-The competition for the trophy presented by Vice-president Mrs. Carden was held at Corps Headquarters where Corps Surgeon Stuttaford set test. which was judged by Sergt. McLean, County Nursing Officer Mrs. Royal Judged the h?me nursing tests. CorpI. Mrs. gamed first place, with Amb. Sister MISS Crouch as runner-up.
Richardson, and many other Brigade Officers. Relatives of the two members who gave their lives-Corporal Henry Richardson and Private Henry W. Ince-were also present.
COUNTY OF STAFFORD
Leek.-At the annual social of the Leek Nursing Division County Officer Mrs. M. V. Penny, introduced by Supt. Miss 1. Pollard, presented awards; whilst Area Cadet Officer Dr. V. C. Veitch, introduced by Cadet Supt. Miss E. Tatton, presented Cadet awards. Tribute was paid to the work of Miss O. Cope, who had given 33 years' devoted service to the Division as Superintendent and had now been placed on the Reserve. To the Misses Morton similar tributes were ;. and each were asked to accept gifts ill token of appreciation. Corps Surgeon S. E. Goodwin and Corps Supt. G. E. Huyton added their tribute to that of Mrs. Penny. Miss Cope and Miss F. Morton thanked the members.
COUNTY OF WORCESTER
RiB and Cakemore Nursing Division.Supt. Miss G. M. Dye presided at the meeting, being supported by PreSident Mrs. Uglow, Vice-presidents Mrs. F. Newell-Roberts and Miss Lewis Cadet President Miss Lyons. A was given to Corps Supt. Mis.s F. M. Fearnside. Miss Dye reported that the Medical Comforts Depot was now well established and that a Cadet Division had been formed. 122 attendances at homes for Nursing Aid duty had been performed and two Welfare cases attended by Miss Dye. Members had undertaken certain and with Cadet training. MISS Fearnside congratulated the division on the work done.
Oldhury.-Members of the Old bury Nursing Division competed for the Dyson Cup recently, the Judges beillg Corps Supt. Miss Fearnside Corps Officers H. Rose and H. G. Mills: CorpI. K. Gallagher gained first place, with N. D. Poole a close second. ViceMrs. S. Gould made the presentatIOn.
Newhaven.-Mr. A. C. Goldsmith (Chairman of the Newhaven U.D.C.) unveiled a tablet in memory of two members of the Newhav€n Division who were killed during WEST RIDING OF YORKSHIRE the last war. A service was held l'n Brl'gho COM D' use orps.- n arch 1 a IVIsIOnal Headquarters by the Rev. N, welcome back was extended to members (curate of Newhaven Parish Church) who had returned home after serving with aSSIsted by the Rev, J. P. Shrimpton th F T (Methodist Church), and the Rev. F. R. e orces. wenty-nine members had (Baptist Church). Those p Fesent served; and presentations were made to 1 ci d M G able to be present by Mrs. W. u. e rs. oldsmith, Asst. Com- Fisher... Those present inchaded Asst. E. Heywood, C0rps Supt. G. H. H. Harrison and Mrs. Wren, DIV. E. ]. Neill, Supt. H D C,. K. PreSident R. J. Bannister, arnson, IV . Surgeon Aske and Mrs. Vice-preSidents P. J. Amy, and A. W As ke , and office:s of the Corps. Supt. FIsher was ill the chair. The fund 130
responsible for providing t.he function and also that sent to members whilst serving had been kept going by whist drives, etc., and Supt. Fisher thanked the committee for their excellent work in this direction. All present stood in silent memory of Pte. Walter Howe who died of wo und s. The chairman thanked Div. Secretary H. Dixon and Div. Storekeeper W. Holroyd (treasurer) for their great assistance. He appealed to those who had returned not to forget that there was still a place for them in the Corps. Mr. Harrison was pleased that so much thought had been given to members whilst away. There was stlll work to be done and stated that in the S.W. Area a lone during 1946 over 11,500 cases had been trea ted.
Spen Valley Corps.-Tributes to the excellent services rendered by members of the pen Yalley Corps "'ere expressed at the annual dinner held on March 6.
Mr, R. Ellis. proposing" The Ambulance and ur sing Division ", said the members
were bound toget.her and fired with enthusiasm to give the people who could not help themselves that help which was necessary. By their work they could bring rays of sunshine into a very dark world. Corps Surgeon R. Dick responded. Asst. Commissioner Harrison said that they were gathered to honour members of the Corps who had gained success during the year and the outstanding member was Corps Supt. Saville, who was retiring after 40 years' faithful service. No one could speak too highly of Mr. Saville's work for the Corps and he wished him many happy years of retirement Mr. Harrison stressed the need for more members and gave particulars of work done during the past year. He also presented a Service Medal to Supt. B. Bamford.
Cadet Margaret Asquith presented Corps Supt. Saville with a barometer in appreciation of his services to the Corps. Mr. Saville briefly replied and thanked the members for their kind gift.
RAILWAY AMBULANCE NEWS
INTER-RAIL WAY COMPETITION
The Preliminary H o und for Ungrouped Railways was held on I\Iarch 21, when Doctors M. 1. Scott (team and Viva Voce Nos. I and 2) and E. S. Abraham (Inclividuals and iva Voce Nos. 3 and 4) judged the work of four teams.
The result was a win by t.he M. and G.N. Joint, being followed by L.P.T.B. (Met. Lines), Cheshire Lines Committee, and Somerset and Dorset (S. and L.M.S. Joint).
General Sir Clive Liddell (Director of Ambulance), who was accompanied by Major-General F. V. B. Witts (Assistant
Director of Ambulance), paid tribute to the interest taken in first aid by railway officials and their staffs; and extended thanks to the judges, Asst. Commissioner H. Dalton (Police) and Mr. J. Grossman, for their great assistance.
The Midland and Great Northern Joint Eailway team will, therefore, take part in the Inter-Railway Final, together with two teams from each of the Great Western, London, Midland and Scottish, London and North Eastern, and Southern Railways.
SOUTHERN
Chatham.-An ambulance quiz held at Gillingham between Gillingham and Chatham Town Ambulance and Nursing Divisions and the Chatham S.R. Ambulance Class was won by the latter team, who received the" Gunn Shield" from the Asst. Chief Constable K. Horwood. Dr. Hoby was the judge, and the question-master Mr. W. H. Hawkins, Class Secretary.
Poole.-The Poole Class celebrated its 21st anniversary by holding a dinner at which the Chairman was Mr. C. Dominey. Mr. S. L. Furnivall (Central Div. Engineer) praised the men for their devotion to the first aid cause and said it was pleasing to note that the Class, formed in 1926, still
have five of the original members. Mr. P. W. Shrimpton toasted" The Ladies ", to which Miss Grindley replied. Mr. F. C. Bryant '(Asst. No. 5B District Secretary) proposed tI·The Southern Railway Ambulance Movement" ; and in reply Mr. F. A. Trott (General Ambulance Secretary) ,referred to the tI family" spirit which pervaded the movement. Mr. W. Butt (No. 5B District Secretary) extended thanks to Dr. R. J. Maule Horne and Dr. Laura Maule Horne for the help they had given to the Poole Class. Mrs. Furnivall presented · nun;lerous awards during the evening and offered to donate a silver cup, to be competed fol' annually by the Engineer's Department.
Ryde.-Several members of the Ryde 131
(Isle of Wight) Class competed in the competition for the "Pioneer Cup " which was judged by Dr. Audrey MacLean
of Basingstoke. Mr. A. Timms vas declared the winner with Mr. Venables as runner-up .
LONDON, MIDLAND AND SCOTTISH
The Final of "Women's Ambulance Competition was held at Blackpool on March 13 and 14, when Dr. J. Roger Sutherland (Rutherglen) and Dr. V/illiam Duncan (Liverpool) judged the work done
Owing to the fact that four teams from Glasgow were unable to get through owing to snowdrifts and other circumstances it was decided thai;. the winners of the competition should hold the championship trophy for six months; and that the four teams from Glasgow would be given a separate competition, and the winning team hold the trophy for the next six months.
lVIr. W. R. Davis (Assistant to the Chief Officer for Labour and Establishment) presided, in the unavoidable absence of Mr. H. J Comber, and announced the results as follows: 1s t Birmingham ; 2nd, Manchester· 3rd' Horwich. Nine teams competed. ' ,
Mr. T. W. Royle (Vice-President of the Company) presented the trophy and individual prizes, and in congratulating the teams on their excellent work, stated that it was in 1879 that first aid was firs t introdu ced on the railways. The women 's competition started in 1929 and, except for the war years, had been held annually.
Twenty ·women held the Company's Go l d Medal for Long Service in First Aid , and many excellent reports had been received from Medical Officers on the work which had been carried out by women on the Staff. On behalf of the Board and Executive Officers he extended thanks to them all for their interest and continued support.
England and Wales Final.-This will be held at Belle Vue, Manchester, on April 25, when the finalists of the SemiFinals will compete for the Championship Trophy.
for
Headquarters: Priory House, 4 Cathedral Road. Cardiff.
GENERAL INTEREST strength, viz., 4,546 in 1938 as against SUMMARY OF PAST YEAR'S WORKING 5,685 in 19 46. Some few returns are still outstanding, but the recorded cases of The report of the Principal Secretary and Commissioner for 'Vales (the Hon John H. Bruce, J.P., D.L.) on the activities of the Priory for \Vales during the first full post-war year-the twentyninth in the hist.ory of the first Priory established under the Order-summarizes the re s ult s of classes held in the various counties, which were at.tended by 14,404 st.udents The figures for each of the three years prior to 1946 have shown a decrease of some thousands from the peale attained in the early days of t.he wa.r so that a drop of less Lhan 500 by comparison with 19-15 can be regarded as some indication of improvement in the general trend of first aid acti viLies. It is satisfactory that the percentage of students successful i.n examinations rose [rom 83·75 in 1945 to 86·49 in 19-16 , when a total of 12,460 awards were issued in the following categories :-
irst Aid CerLificates Preliminary First id Certillcates VouchersMarine CertilicaLes
Home 1\ursing CerLi.ficates
Home Hygiene CerLificates .
Preliminary Child ·Welfare Certificates
First _ ieI in l\Iines Certificates
id in Mines Labels
1,492 2,198 311 65 309
accident and sickness treated number 59,390. Routine and special duties involved a great demand upon the tim e and services of the Brigade membership. Nursing members have responded to innumerab le calls for assistance in the nursing of patients in their own homes, while 765 attendances were made at clinics, and 7, 383 hours of duty were given in hospitals, nurs e ries , and blood transfusion centres. There are 109 ambulance halls ensuring permanent headqu arters for Brigade Units, most of them accommodating Medical Comforts Depots, of which there are now 146 operating in Wales. The articles issued during 1946, totalling 14,971, works out at forty-one per day throughout the year including Saturdays and Sundays.
The Priory Motor Ambulance Transport Service dealt with the conveyance of 26,655 patients, mileage travelled being 481,393-higher totals than ever previously recorded and showing increases of 3,299 and 67,625 respectively o n 1945 It is of interest to note that the 1946 figures represent an average removal of three patients per hour (day and night)
Preliminary Home Nursing Certificates 3-10 the ·whole year through. Since the in cep13 tion of the Service 319,299 cases have been removed in Priory ambulances, involving an aggrega.te mileage of 5,569,674. Limousine ambulances for long-distance work are very much in demand; and many appreciations from various authorities and individuals are on record. During the year twenty-eight ordinary and 10ur limousine type amb ulances were in com-
The register of members of the Medical mission, serving twenty-two co-ordinated Profession associated as Lecturers, out-stations , including two additional Examiners and Brigade Surgeons has ones established at Penrhiwceiber and been und er review in each of the counties Swansea, and the Cardiff Station which w ith a view to securing the interest of is eq uipped with three ambulances suppledoctors r eturnin g from service with H.M. mented at times by a fourth vehicle. The Fo rces with the that some welcome Priory h as contracts with four local additions have been made to the panel a uth orities, one general hospital, fortyof doctors, now numb ering 632, to whom three colliery and other companies co verthe Priory is deeply indebted for their in g 52,000 employees in respect of conveyindispensable services. ance from colliery and works premises.
The num erical strength of the Brigade During 1946, 162 colliery lodg es and other as shown by the returns rendered as at bodies of employees totalling 33,500 December 31 last, and after deductin g all subscribed; and forty-five contracts inactive units, stands at 15,642. This is a covered approximately 8,500 "outside" decrease of 1,908 g n the previous year, subscribers unconnected with any parbut it compares favourably with the total ticular industry. The service is availof 12,794 for the pre-war year, 1938; able at all times of the day or night to and a particularly promising aspect of the general public at moderate nonthis comparison is the proportion of Cadet su bscriber charges.
Mr. T. W. Royle (Vice-Presicl(mt of the L M S R l ) . Cup to eaptain of the Birmingham team al way , the Championship in the are, from left,' Miss H. SoAmbulance Competiti0t;l. (ASSistant to the ChIef Officer for Labour and t) C fficilf)' Mr. W. R DaVIS (DeIDuty Mayor of BiackID00l), anal Mrs. Hill (Mayoress Rhodes Marshall
The 'Welsh Home Serwce Ambulance cars in Wales, stationed mainly in industrial areas and manned by voluntary drivers and attendants, are entirely independent of the Priory Service, being controlled by a Committee equally representative of the Priory for vVal@') and British Red Cross Society, of which the Principal Secretary and Commissioner for Wales is Chairman. The number of H.s.A. Stations, which are operated by units of the Order or Society, was increased during 1946 from 31 to 47, the addition of 15 of these having been made possible by a further issue of war service ambulances.
NEW APPOINTMENTS
The Prior, the Earl of Powis, has approved the following appointments to offices formerly held by the late Dr. S. B. Turner :-Dr. Edgar Llewellyn as Assistant Surgeon-in-Chief for Wales and Mr. W. J. Skyrme as Assistant Commissioner, Caerphilly County Area, Glamorgan. Dr. Llewellyn has a long and varied experience of Brigade Service, having served in an admirlistrative capacity as Commissioner for the City of Cardiff and on the medical side as Divisional, Corps and County Surgeon. Mr. Skyrme's appointment is a recognition of twenty-three years' service com-
mencing with his enrolment in the Deri Division, and subsequent promotions from Divisional to Corps and in 1938 County Officer rank. Both Officers were accorded a warm welcome at the Ambulance Committee of the Priory on March 25.
CENTRE REPORTS BOROUGH OF MERTHYR TYDFIL
In his report on the past year, the Commissioner, Capt. W J. Canton, states that the membership of the units in his Centre has dropped by 131 on the previous year to 764 at the end of 1946.
The decrease in ambulance memhers is mainly due to migration from the area owing to unemployment following the stoppage of war factori es, and the reduction in Cadet strength can be assigned partly to transfers to the adult Divisions.
On the other hand it is m os t encouraging to find that there is a slight increase in the nursing membership. Reference is made to the Inspection of the Cen tre by Sir Leonard and Lady Twiston-Davies, Assistant Commissioner for Wales and Chief Officer Nursing Cadets Wales, respectively, whose visit and inspiring remarks were greatly appreciated. A happy feature of the year's work is the acquisition of an excellent headquarters
in Merthyr for the Merthyr Borough Ambulance and Nursing Divisions which have not before in their forty years' history been possessed of a home of their own. The new Centre Chairman, Lt.-CoL Ronald L. Thomas, who succeeded the late Mr. Tom Andrews, J.P ., is taking a keen interest in all the units in the Borough.
BOROUGH OF SWANSEA
The appointment of Mr. Benjamin Baddiel as Treasurer of the Centre has just been notified by the Commissioner, l\Ir. Hugh S. Cann, in submitting a report on the part year's work. The chief incidents during 1946 have been the re s ignations of the om missioner, Dr. Urban Marks, after tw enty-fivc ycars' service, and Lady ounty Llperintcndent 1\1rs. 1arks . Mr. Hu gh Cann was promoted irom Assistant Commissioncr to Commissioner and Dr. Leslie \\'. IIefferman, from Corps urgeo n to sist.a nt. Commissioner, Dr. J. Shibko, Divisional urgeon of the BrynhyLryd Divi ion, becoming the Corps urgcon. During October t.he Centre sufIe red a very severe blow by the sudden death of Mrs. Eth I l\1. B e nnett. Mrs. Bennett has h eld the position of Lady Corp uperint.cnd c nt since 1938 and was dearly beloved by all mem bers Her loss "'ill be felt for a long time as she was at all times an inspiration to members by her kindly int ercst and ncouragement Every effort is being made by the Centre t.o take up all pre-war activities as members ret.urn irom the Forces and uniiorms can be provided for them and new members. The huts at the Bays were staffed during the summer months and full duties carrjed out at the various places of amusement. Two Medical Comforts Depots have been opened, one in the Brigade Headquarters, Hafod, and the other at Clydach. One new Cadet Division has been formed in connection with the Hafod Ambulance Division and the Cl ydach Merthyr Ambulance Division was resuscitated in September, 1946
OBITUARY
Couuty Officer Frank DearIe, B.E.M.-
County basis, Frank Dearle was promoted to County Officer; an Officer who expected a great deal from members, but who was also at the disposal of all members. In 1938 he organized a scheme for the evacuation of Oxford Hospitals to make room for patients removed from the Lond on Hospitals; and he had a great deal to do with the F.A.P. Organization set up in Oxford. He was awarded the B.E.M. for his work. Those who visited the pre-war Brigade Finals would always see him acting as a Marking Sheet auditor. He was an Officer of the Order. He died very suddenly in his office on March 3 ; and those left behind will find their tasks much easier because of the marvellous organization set up by him.
Supt. George Wilson.-We regret to announce the death of Mr. George Wilson, who joined the Blackpool Division in 1899 and was an active member until 1940, when he transferred to the Brigade Reserve. He was Divisional Secretary for over twenty years and organizing secretary for the Argenta Cup Competition for a long period. He was appointed Superintendent of the Blackpoo l Div ision in 1932 . He was a Serving Brother of the Order.
Sergeant Thomas William Hine.-After being a mem ber of the Woodstock Divis ion for 41 years Mr. Hine passed away on February 25. He took his first aid certiiicate in 1906 and for a time held the position of Divisional ecretary. He received the Service Meda l in 1937 and a Vellum Vote of Thanks in 1930 . He was placed on the Reserve in 1939.
Amhulance Sister Kathleen Lynch.The death is reported of Amb. Sister Kathleen Lynch, a diligent member of the Eastbourne Nursing Division. Prior to joining this Division she spent many years with the Guildford and Hastings Divisions of the Brigade; and would have been due shortly for the second Bar to the Service Medal.
The Chief Commissioner Brigade Overseas regrets to announce the death of Miss Sheila Mackenzie, S.R.N., formerly the Nursing Officer of Wellington (St. Paul's) Nursing Division, and later Dominion Commandant in New Zealand of St. John Voluntary Aid Detachments.
With the passing of Mr. Dearle the Brigade has lost a member whose record dates from 1897, when he joined the Brigade. In 1899 he was appointed Divisional Secretary at Oxford and when the Oxford Corps was formed. in 1905 became Corps Officer. In that rank he It is now possible to supply more copies arranged all the unloading and .tranSP?Ft of The Gazette. Divisions Fequiring of patients from Hospital. Trams WhICh nl0ntlhly parcels, also m,em beFs FequiFing arrived nearly every day at Oxford copies sent by post each should during the 1914-18 war. In 1929, send their orders to the Publishmg Office, whe n Oxfordshire was organized on a 46-47 Chancery Lane, London, W.C. 2. 135
MORE COPIES
(Assistant Commissioner ' for Wales), conducting the lnspeCUon of Umts In 0 e Borough of. Merthyr Tydfil Centre. Asst Commissioner Melbourne Thomas, ChIef Constable, IS standing on the extreme right. 134
INTERESTING CASE REPORTS
CASE REPORT No. 319.-The Officer-in-Charge of the Southern Area, o . I (Prince of Wales's) District, S.J.A.B., reports the efficient assistance rendered by two members of the No. III (South Suburban Gas Co.) Division to their Divisional Surgeon in the following circumstances :--: .
On January 12 Pte. F. Plummer while at work r ece1ved a call to an. accIdent in an ad joining plant. On arrival he found one man was entangle.d III a large sprocket wheel jammed against some enclosing iron casing. Th1s "vas beyond all aid. So Pte. Plummer concentrated on a man who was also lllvolved and had a badly torn arm. He also sent for a Doctor and am bulance a nd also another member of the Brigade, Pte. J. Ead.
The doctor happened to be the Divisional Surgeon, Dr. R. Stanton, and he immediately took charge. He attended to the injured man and was satisfied with the first aid rendered. The only way to extricate th e dead man b eing by reversal of the machinery, Dr. Stanton instru cted Pte. Ead in th e method to be adopted.
This called for great care and ingenuity on the part of Pte. Ead. Thi was duly accomplished and th e problem then was to get the deceased man to the ground from a height of over 70 feet. Pte. Ead sent for a t( Niel-Robertson " stretcher; and with the aid of two other workmen he successfully 10\\' ered the deceased to the ground. The whole incident was carried out to the satisfaction of everybody concerned. I must add that Dr. Stanton, Ptes. Plummer and Ead were thanked by the Management who also asked me to convey to the members of the Division their congratulations on our training in an emergency.
CQMMENT.-This report tells its own tale and wins for all concemed c01' dial congratulations on good work well done.- I CORBET FLETCHER.
CASE REPORT No. 320.-Messrs. George Mount & Sons, Ltd., of Canterbury, report the efficient performance of first aid by members of the Canterbury Division , S.J.A.B., in the following circumstances :-
On February 7 a man employed in a large nursery was painting inside the roof of a glasshouse when he fell from the staging (a distance of IO fee t) on to th e raised flower bed which was edged with boards.
Corporal Wead, who is an employee of the firm, was sent for, and on his arrival he f.ound .the man unco.nscious with fixed and unequal pupils, his hands clasped behllld his head, bleedmg freely from the bridge of his nose, and breathing in a stertorous manner. The patient was thEm covered with all overcoats available. Corporal Wead learned from a bystander that the man had struck the edge ofthe bed w.ith his back and had not moved since, and that he (the bystand er) had lowered pabent on to the path of the greenhouse which was 22 inches wid e and 16 inches deep.
A cyclist was despatched to the Office with a note requesting that the ambulance be telephoned. Another message was sent to fetch Pte. Neal, who is also an employee of the firm; and.a message was sent to the gate of the works to meet the ambulance and gu1de 1t to the scene of the accident.
The. ambulance arrived in record time, but the two St. John members had the knees, and ankles of the patient bandaged together by then. The of the ambulance was folded lengthwise and with much ass1stance,. but gentle care, the patient was rolled to one side to get the sheet beneath h1m, gently rolled back and to the other si<il.e and back again on to the sheet. He was then carefully lIfted on to the stretcher covered w ith blankets and conveyed to the hospital, a distance of two miles. ' was admitt ed to hospital with a fractured spine, suspected fracture of pelv1s, suspected fraeture of base of skull. The time taken fwm the moment
Corporal \iVe<;Ld was called to the scene until the arriva l in hospital was approxi33 mmutes. The House Surgeop. remarked on the manner in which th e Job had been tackled and congratulated all concerned.
QUESTION S A ND ANSW ERS
Injury to Liver an d Fractured C lavicle
M. G. (Falmouth) .-In th e ca se of liv er ' i njury and fractur e d cl av icle w i th whi ch yo u d ealt in th e F ebruary iss u e of Th e Ga zette , I note that th e treatment con s id er ed co rrect w a s a St. J o h n sling onl y and a co ld compress over li ve r.
Thinking over th e co mfort of t he pati ent , I wo uld like t o ha ve o n th e loop b a ndage over each a rm ti ed at th e WJth a pa d in th e injur ed a r mpit , b ecau se t h e bracmg back brmg s r elI ef t o th e seat of fra cture a nd if t he pati en t f old s his h ands in front n o b od y bandage I S n e cess ar y.
I wo uld like t his b a ndage inclu ded in o ur T extbo ok.
I f, as s ta te d in your letter , you des ire to thi nk of his comf ort , you wo u ld no t put a patient, who is sufferi ng fro m hcem 01'r hage f rom an in tern al organ , to the d iscomfort of the movemen t n ece ssary for th e appli cation of th e loop bandage. I n shor t, my reply in th e F ebru ary iss ue of The Gazette needs no m odificat ion -N C. F.
Treatmen t o f Venou s H ce m o rrhage
G P (A cto n).-As a Brigad e S ur geon I would 'we lco m e yo u r co mm e nts on t h e followin g p roblem :-
Rule 6 on p I 28 of th e T extb ook, und er " G ener a l Rul es fo r T r eatm ent of vVo und s with Ven o u s H cemo rrhag e ", tells fir st aid er s t o a ppl y a fi r m bandage on th e s ide a w a y fr om t h e h ear t. Rul e 9 on p. 2 6 of The Supp lemen t , h owe v er, t ells fir st aid er s t o a p p ly a firm b a nd age above th e w ound . I wo uld like t o know if the instructio n r efers t o treatment of both arterial and ve n o u s hcemorrh a ge. 1£ so, I think th a t in th e t r eat ment of v enous hcem o rrh a g e th e b a ndag e should be o n t h e s ide furth est fr om t h e h eart.
T h e instru ctions on pp. I9 to 26 of T he S up plem en t sup er se de th ose on pp I04 to I 30 of th e T extbook. T o m e, th er efore, it w ould app ear that th e R evisi on Commi tt ee ha d as i ts obJec t the simplification of the ins tru cti on s on th e co ntro l of hcem orrh age because so many individuals tak e one co urse of lec tures only liVi th such in divi du als th er e was always a tendency to r u sh to th e to u rni que t wi th th e r es ult th at p atie nts suffering from venous hEEmorrhage had th eir condi ti on m ad e w or se; and I have had p r actical experience of th is in ca ses brought to m e.
B riefl y, th e i dea in T he S upplement as it appear s to me is to con trol aU varie ties of by digi tal p ressure , by pad and bandage or by th e bui lt -up me tho d m R 1! le 8. If. th ese me tho ds f ail, th e case is obvious ly one for dra s tic me asures, to th e .{; u itmg off of a ll blood SUPply to the limb , this being the effect of th e tig ht co ns tri ction or the elas tic bandage. Such ca ses, however, ar e very f ew and fa r between. In connec twn , T he Supplem ent w arns fir s t aid ers to 1 ' ela x th e bandage every 20 mtnu tes but fa tl s to stress th e urgent n ee d for obtaining medi ca l help at th e earlies t possib le moment
W h en all is said an d d one, I am sure that, from your experiences a s lec turer , you mus t h ave fo u nd th at th ere is rea l difficulty in teaching th fY contro l of h cemorrh age by pressure on th e ar tery , S o perh ap s the me thod now ta ug h t in Th e Su pplemen t is th e s afer for g en er al use .-N . C. F .
Reller Bandage for Ear
J. S (Cricklewood) .- (I) Wo ul d y ou plea se t ell m e if it is inten ded th a t a complete horizonta l turn sh o u ld cove r each obliq u e reve r se tu rn of th e bandage , 138'
I t's just broken the skin! But that's enough to give infection a start.
one 01' other or all 01 the three races of germ&, Streptococci, Staphylococci and B.pyocyaneull are found in every skin infection common to this country, and ANT IPEOL OINTME NT contains the (antivirus) of these germs Healing is expedited b y the proved ingredients of the ointment, and septic development is stopped or pr evented by its antivirus sterile vaccine filtrates. ANTIPEOL OINTMENT is unsurpassed for BURNS and SCALDS, for it is microbicide and non-adhesive, and dressinp do not require to be changed eYerY day .
RHINO-ANTIPEOL
affords rapid relief of COMMON COLDS, INFLUENZA AND CATARRH Cootainin, the antibodies of the germs common to infections of the nose and pharynx (Staphylococci streptococci. B.pyocyaneus, pneumoc,occi, bacilli, enterococci, M catarrhalis, B.Pfeiffer), RhiDo-AntipeoJ is not just a palliative, but is a remo\'er" of the c/Juse of the infection. During epidemics it is the ideal pr&ventive of microbic development
OPHTHALMO-ANTIPEOL
is • aemi1luid ointment, more convenient than the ecdinary AntipeoJ ointment for ocular infections and , lesions Eyes affected by smeke and dust ace soot hed almost immediately by the application of Ophthalmo-Antipeol, and the antiVU'UI prevents germs from developing.
OUNIOA.L SAMPLES ON REQUEST FROM MEDICAL-BIOLOGICAL LABORATORIES, LTD. CARGREEN ROAD ' , SOUTH NORWOOD, LONDON, S.E.2S
or is th e obliqu e r e v e rse suffi ci ent? A lso (2 ) sh o uld ro un d t h e f o r eh ead cover th e previou s o n e complet ely or Ju st t wo-th Irds. T h a n k y ou
(r ) Th e J.VLt1'Sing T extboo k gi ves the ans we'r to your on p. 22 where y ou are told that the h01'izon tal turn comes back to the star tmg pO 'Ln t and that the secon d tu rn f01' m s the oth er turn which cove r s p ar t of th e dre ss ing. You are then told to rep ea,t, whi ch mean s that th e next hori zonta? turn mus t be complete and a fresh tu r n w'Lll mak e the second oblique tur n. ' .
(2) The second horiz ontal turn co m plete ly covers th e.firs.t You w'Lll find on tn al that , if this second turn is placed at a high er level, 'L t w'Lll reach th e narrow part oj th e fo re head and tend to slip .-N . C. F.
Women and Stretcher Exercises
1. J. (Wakefield) .-1 would like y our opini on a nd advi ce o n an incid e nt whi ch took place at a recent examination f or s er geants
I w as called upon to take the position of N O. 4 in th e s tr et cher sq u a d, and took my place beside NO.3 at the should er on th e right of th e " pa ti e nt " Th e instructor told us to kneel on the left kne e t o lift th e p ati en t I protested that I may n ot be able to lift and support h er in that p os ition. I was t old that I s h o uld obey the instructor; and that, if it had b ee n a co mp etiti on, I should lose marks for all the t eam for arguing. Being nerv ous a nd p erp lexed I su b sided and obeye d .
On lifting and lowering the patient I f elt a draggin g on th e abdominal m u s cle s. I made no complaint as I thought it would s o on p ass off. B u t a few ho urs late r I could not stand upright without severe pain .
I wish to know if the injury to myself w ould b e throu gh pe r sona l weakness, and if another bearer would not have felt an y strain Th o u g h I have d o n e it before as described in the first aid Textbook w ithout an y ill-effect, as b y k n eelin g on the right knee and leaning over to the left the abd o m e n is su ppo r ted o n th e left thigh. vVhen patient was lifted instead of s upp orting her sho ul ders m y kn ee was below h er shoulder-blades.
I must add that w e were rather cro w d ed , b ei n g in .a lar ge room, not a h a ll , and I do not think that the examiners saw my p o in t th at we were on the wrong side of th € pati ent for that order.
From a phy sical point oj view women sho u ld n ot a tt emp t to lift p atients, speci al ly Jr om the ground , although they should know enoug h oj th e dri ll t o be able to ins tru ct bystanders. If, however, they desire to practice th e m ovemen t the p atien t s ho u ld be a dummy and ·made Jr om a roll of cloth
Incidentally your lett er would appear to reveal th e commi s si on oj three err or s(r) The liJting oj patient during Stretcher Dri ll s ho u ld be carried ou t by m ales, a s i s laid do wn on p. 6 oj the Textbook un der" S ixt h Lecture " ; (2) The us u al po si tion s Jor Bearers 2 , 3, an d 4 are on the leJt si de oj the patient; and (3) the leader (not the instructor) deci de to place B earers 2, 3 , and 4 on the r'Lght 5.'Ld e oj th e pati ent in accordance with th e footnote on p 20 7 oj th e T ex tbook, then th es e B ear ers should kneel em the right kn ees.-N C. F
Sc;hafer's Artificial Respiration
. J. B half a lifetime sp ent applying and practising r esuscitatIon, I must dIffer WIth your correspondent on Point r which w as publishe d under the heading in the Febru<1:ry, issue of The Gazette . By far the greater number of revIVmg apparatus have therr 'exhale valves " oIl. the right sid e of the face mask. It follows that if the patient's head is turned, the l eft cheek should be on the left hand. This position prevents obstruction 'to the exhale valve when applying artificial r espiration in cemjunction with reviving apparatus, 'whicln., of course, should be used whenever available.
Y letter has been to a medical colleague who has speci al knowledge oj acc'Ldents and res(.;ue work 'Ln mmes and who has replie.d as follows :_
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HUMAN OSTEOLOCY, ANATOMY, ETC.
= Made Under the --Supervision of Just New 1 Professor Issued c. F. V. SMOUT, Birmingham University.First Aid Fracture Chart
Size 28 X 40 inches Price 17/6
First Aid Dislocation Chart
Size 20 X 15 Inches Price 7/6 Postage 1/- extra.
Two Charts. coloured on cloth with rolle,...
ADAM r ROUILLY & CO.,
18 Fitzroy St., Fitzroy Square
LONDON, W.I
Telephone: MUSEUM 2703.
141
(1) There is s%ch a reviving apparatus used mi",!,es. It is called Novo;.: , is made by S iebe, Gorman b Co., Ltd., and is adverhse d m The Gazette.
(2 ) It is %sed to s%pp ly oxygen and carbon to lhe apparently drowned or asphyxiated.
(3) Usually the mines are equipped with one such apparat'llts on the. su,rface and one or two underground. All rescue stations and resc,!",e teams .as part of their equipment. It is, therefore, to be found at all maJ.or 'Ln, mmes:
(4) It is likely that a victim will hav e to receive resp, 'L'Yatwn w,h'z,ls t sttll in irrespirable air. liVhen this happens, the rescuer carnes hts own a'Ll' SUPply of oxygen on his back and administers oxygen to the victim from the Novox apparatus which he carries.
Yo%r previous correspondent makes no mention of reviving apparatus and merely quotes the p, one position for Schafer'S Method of a11 tijicial respiration; wit hout additional aid. Surrely, should th is position interfe11 e with the exhale valve, it would be a simple matter to reverse i t . As a matter of fact the construction of the facepiece is always the same and the valve is on the right side. It is made either of metal eJr of plastic; and i t would be difficult to obstruct even when the patient has his right cheek on his right hand.-N. C. F.
Treatment for Fractured Spine
M. M . (Truro).-Some discussion has arisen in our Divisi on at Truro as to the number of bandages to be used for transp ort of a case of fractured spine.
The pcint in question is whether paragraph 2 of the Method" A " on page 13 of The Supplem ent to Textbook intends the use of ten bandages, i.e. bandages passed from alternate sides and w(')Tked into position under the h ead, sho ulderblades, hlflttocks, thighs, and calves, leaving two in each position w ith an equal number of loops on either side of patient, or the use of five bandages passed alternately under th e pati ent leaving one in each position with thr ee loops on one side and two on the other.
The soluticn appears to rest on the correct interpretation of th e word" alternate " -whether it applies to the placin g of the bandages starting from th e head of the patient and working dcwnwards or from side to side of patient. My personal opinion is that ten bandages g ive better results and should be used if possible.
Would you be good enough to publish a ruling on this point in The Gazette?
The number of bandages -:equired for transport of a case of fractured spine is jive; and the reason for passmg them alternately under the patient is that the nq:rrow parts of the bandages w here the knots are tied shall not be placed all on one side . Had ten bandage s been required Rule 2 on p. I3 of The supplement to Textbook would have read_ rr pass looped broad bandage s from both sides . ... "-N. C. F.
33 YEARS AFTER
The following story is taken from the Y orkshi1'e E ve ning News :_ October, 1914, the hospital sih ip RohzUa was sinking. . .. Aboard were Mr. E. Eastwood, of Bamoldswick, and his clos€ fri€nd, Mr. W. HarriSOR, (!Jf Coventry. They jumped together for their lives.
But when the roll ·was called there was no answer to the name of Harrison. Now33 years later-Mr. Eastwood has received an inquiry . "Do you remember anyone of the name of Harrison aboard the RQhiUa ? "
The reason is that the seas had just gIven up-at Whitby-a silver medal of the St. John Ambulance Brigade. It is inscribed with the name" W. Harrison ".
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THE ST. JOHN GAZETTE is published on the 15th of each month. The Annual Subscription is 58. p08t free; linale copies 44., by post Sd. REPORTS AND PHOTOGRAPHS should be addressed to The Editor St John's Gate. London, E.C.I, and Ihould reach him not later than the z8th of the SLUdBSCRIPTIONS and ADVERTISEMENTS should be forwarded to British Periodicals t •• 46 -41. Chancery Lane, London, W.e.2. , 142
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'NOVOX' and 'NOVITA' Oxygen + CO 2 or Oxygen RESUSCITATING APPARATUS fOt the apparently a.phyxlated or drowned.
SMOKE HELMETS of all Patterns. 'PROTO', 'SALVUS' & 'FIREOX' OXYGEN BREATHING APPARATUS
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W A NTED.-Lady Officer's black. costume, bust 40 in., hips 44 in. S en d paruculars and price to S J 64, c/ o Publishers.
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T REATMENT AND REMEDIES FOR POISONING.-A handy quick reference chart which shows at a glance the u:eatment 30 different types of poisons. Compiled by DIV. Supt. A. E. Hawkins. Signs. and Sympt<;>ms; Immediate Treatment; Emeu.cs; Stimulants; Demulcent Drinks i ArtifiCIal Respiration; Later Treatment. Pnce 9d., post free IId.-FoUNTAIN PRBSS, 46-47 Chancery Lane, London, W C. 2.
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R Etched (printed) your own brand" S.J.A.B." Best quality British. Fits all 3-peg razors are equipped to supply .very small quantlues. Sample, price, and paruculars free.-RoBERTS BROS. & CO., 143 Town Street, Beeston, Leeds, II.
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