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Sunday, August 14, 2011

Improved Civil War Ambulances


The Civil War was a landmark in the evacuation and treatment of battlefield casualties. It was the first mass evacuation of wounded troops and its lessons and innovations were quickly adopted in Europe. “The American War” had introduced a trained ambulance corps, improved and designated ambulance vehicles and the use of field hospitals near the battlefield. These systems became standards of battlefield and disaster medicine.

Early in the war, the wounded lay on some battlefields for as long as three days. No designated vehicles were assigned to ambulance duty. There were no trained attendants to carry stretchers. Men deployed to the task were usually those too weak, sick, drunk or frightened to fight.

Major Jonathan Letterman, Medical Director of the Army of the Potomac, instituted a plan. Letterman’s design was a model of organization for medical support. The elements of his concept are still used in modern wars.

Major Letterman’s plan called for transporting the wounded to the hospital in dedicated vehicles, dropping them off with their bedding, picking up new supplies at the hospital and returning to the front. The ambulances of a division would move together with specified personnel to collect the wounded from the field, bring them to dressing stations, then to the field hospital. The plan was implemented in August of 1862 with regulations for the organization of the ambulance corps and the management of ambulance trains.

Jonathan Letterman’s Ambulance Corps was a huge improvement over the previous methods of evacuating casualties. The new system was partially tested at Antietam on September 17, 1862, the single bloodiest day of the war. The field was cleared of its 23,000 casualties within twenty-four hours.

In March, 1864, Congress published General Orders No. 106, an act (Public 22) to create an Ambulance Corps for all the Union Armies. By this time, the Corps was in general use throughout the Union Army. The Confederates had adopted a similar program, although they never put their ambulances under the medical service, keeping them under the quartermaster.

The Americans also pioneered specially designed trains and boats to transport the wounded. The Civil War ambulance-to-field hospital system remained in use by Americans and Europeans during all large wars for almost a hundred years, until the introduction of helicopter evacuation.

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