Speakers and Recruitment Section Workers of the Red Cross blood Donor Center Procurement Division
Excerpt From a Talk Major Henry Swan Gave on His Return From Duty With the 5th Auxiliary Surgical Group in Europe.
Major Swan came to the Blood Donor Center to meet with Blood Donor Chairman of cooperating groups. His purpose was to give
them an understanding of the extreme gravity of battle wounds, of the tremendous part plasma and whole blood transfusions
had in saving the wounded, and of the necessity of whole blood throughout the long period of treatment of the wounded, the
sick, and the prisoners of war not in Fitzsimons General and other nearby military hospitals.
Major Swan: I was a surgeon and I had a team. We comprised what was called a general surgical team. We moved around from hospital
to hospital - we were not attached to any one unit. Where a hospital was set up and casualties were coming in they would need
additional surgical personnel to get there and take care of these men. We would be called upon. Then the front would move
ahead, or, if the fighting slackened at that point and some other point became the pressure point, we would leave and go on.
The Field Hospitals were designed to take care of the non-transportable patients. Thus any soldier who was so seriously hurt
that delay in treatment or having to move him very far would jeopardize his recovery, would be treated at a Field Hospital
and that would be located very close to the spot where he was hurt. My experience was one of which I saw a very large number
of severely wounded boys. I was trying to think of any patient in a Field Hospital who had not received any plasma or whole
blood or both, and I couldn't call to mind, at the moment, anyone. In other words, about 100% of these boys received plasma
and blood. How much plasma and blood did they get? That varied with the severity of the injury and how long since the soldier
had been hurt. For instance, if you can get a soldier immediately you can prevent a lot of shock, and a lot of blood loss,
but it is different if he has to lie out in the field for a day (and that is true particularly of our paratroopers who advanced
so rapidly) or if, due to the technical situation, they cannot be evacuated, - that is, if they were in such a position that
nobody could get to them without being killed. Those boys had time to suffer shock, and they would need a tremendous amount
of both blood and plasma. If we averaged up those patients in a Field Hospital, I think it would be conservative to say that
each had to have at least four whole blood transfusions, and four units of plasma. Some of them had much more than that. and
some few, somewhat less.
People do not realize the tremendous size or terrible nature of some war wounds. When a high-explosive shell goes off it is
splintered into fragments what whirl through the air and cover a large area. When it goes in it is red hot and it sears and
burns. Because it is big and heavy it has a lot of momentum and the body has to take the shock. As such a shell fragment goes
in, it takes with it clothing, skin, etc., and carried it into the depths of the body. I had one soldier who was hit where
his pants pocket was, and, scattered throughout the depths of a very deep wound, were parts of his K ration, the key to open
the can, and a considerable portion of the "Stars and Stripes" of that morning. When a person suffers that type of
injury, if it goes into the chest you have a whole in that chest that you can stick your fist in. That is a shocking, terrible
injury. These are wounds of which the boys in the last war died.
It is interesting to note a comparison between this war and the last one. For instance, a penetrative wound in the abdomen
has 50% or 60% fatality count; a wound in the chest about 35%. A combined wound of both chest and abdomen was 95% to 100%
Such wounds were what we saw all the time in the Field Hospitals. The comparative fatalities in this war were from abdominal
wounds, 15% to 20%, from chest wounds 10% to 15%. You can see the tremendous difference there. I believe that if one averaged
these figures and thought in terms of the last war, the fatalities in Field Hospitals would have been in the neighborhood
of 50% or 60%, whereas actually it ran around 15% in this war. So, actually, these boys did not die of infection -- we had
sulfanilamide and penicillin. But the chief reason was that in this war we had plasma, and we had blood. Those boys who had
terrible injuries could never have been gotten into shape for operations if they had not had plasma and blood. So I think
it is conservative to say that between a quarter and one-half of their wounded boys who are walking around the streets today
would have been dead if we had not had plasma and whole blood for transfusions.
I might tell you a story. When we were in Normandy we were in a Field Hospital and under blackout conditions. We had a boy
who had a particularly bad injury. It tore his spleen and his stomach and other things. Such an injury causes tremendous hemorrhaging.
He was bleeding very fast. According to our records he received four whole blood transfusions and four units of plasma before
operation. When he was first brought in he was very cold and pale, had a very low blood pressure and a rapid pulse; but by
the time he had this blood to replace the blood lost, his blood pressure came up so we thought it all right to operate. About
everything happened. A blood vessel inside got loose; in other words he started to bleed again. At that moment we had an air-raid
and one of the bombs hot the generator and the lights went out. I had my finger on the blood vessel. We couldn't get a
pulse, as the boy was dying, so we tried to pump blood in. We got a flashlight and by the aid of the flashlight we got a clamp
on the blood vessel. Finally the air-raid was over, the lights went on and we finished up. The anesthetist saw that blood
was not going in fast enough so he pumped it in faster. Then we pumped it into three places, one in each arm, and one in the
ankle. Finally he came back to life and we got a pulse and blood pressure. We took him back to the ward and next day he had
some more blood. In all he had twelve transfusions of blood and right of plasma. A few days later he went back on a plane
We had another soldier who was a great big strapping man, a very courageous fellow. A piece of shrapnel had hot a major blood
vessel in his leg. This vessel is about the size of your finger and you can imagine what that meant. He, too, had a severe
hemorrhage inside his abdomen, and he received ten blood transfusions in a period of two hours in an attempt to get him strong
enough to get him on the operating table. Throughout the operation he continued to have blood and plasma. It was a difficult
business, trying to find that blood vessel. He seemed to have died on the table, but he kept on breathing and as long as he
kept breathing, we kept on working. As soon as we got the blood vessel fixed we saw that he was still breathing. Then we let
the plasma in for about half an hour. So gradually, the blood pressure started to come back; we managed to get through the
procedure all right. He was a very, strong, courageous fellow! Two or three days later, I was talking to him, and he said
"Doc, we had a pretty tough time of it, didn't we?" I said, "Yes, soldier." He said, "You know, for
a time there I didn't think we were going to make it." The spirit of those boys was wonderful. I guess he is around
and about, at least he was O.K. when he left.
Most people do not realize, -- now that VJ Day has come and gone -- what our severely wounded men still have to endure. Word
goes around that we don't need any more blood donor centers. But the actual fact is that I a fellow was severely wounded
it may be months or years before he is out of hospitals. If you get a shattered leg bone you can look forward to two years
at least. At the end of that time you may find it can't be mended, and it will have to be cut off and the man has to have
an artificial leg. Sometime a man has his face blown off. It is a terrible physic injury to have your face destroyed. Think
what it must feel like to realize that you are a horrible sight; that you can't let people see you. Those boys, with modern
plastic surgery can look forward -- their faces can be restored so well that you won't turn around to look at them. Unless
you look closely you won' realize that one had his jaw shot off. Those things take time, and it may take ten, fifteen
or twenty operations over a period of time. If you have a badly injured leg, you may have to have many bone grafts; infection
may set in, and you have to combat that. Maybe after all that, the leg is six inches too short and you may have to transfer
a bone from the other leg.
What I am trying to tell you now is that months after VJ Day there are thousands of American soldiers who are still undergoing
major surgical operations, and they will continue a long time and these fellows need blood because they lie around in bed
with no exercise, they don't have the strong vitality which an active life gives. On top of that they may be fighting
infection or disease. The boys coming back from the Pacific, over and above all their other difficulties, are fighting serious
malaria and fever on top of everything else they have to contend with, They have to be built up. It is necessary to treat
the total patient, to build up his reserve, to build up his blood, and make him strong. Then when he seems strong enough,
he is taken in and operated. If it is a bad operation and it knocks him down again, it may take six months for him to gather
strength for a repetition, and that knocks him down again. There's a lot of them, literally thousands, and I suspect tens
of thousands, who are still in Army General Hospitals, still undergoing intermittent surgical treatment. At Fitzsimons Hospital,
for instance, they are using ten pints of blood every morning in the operating room. That does not include blood given on
the ward afterwards or given to the fellows who have TB or other diseases. This is just one hospital.
The Denver Red Cross Blood Donor Center has done a swell job. Because of the steadfast loyalty and extra generosity of the
Denver donors, and the splendid record of service which this community has built up, you are being asked to continue the work
in the knowledge of the continuing need. That need will continue for many months to come. These boys need this blood, and
I am sure you will see that they get it.
(Blood Donor Center Procurement Division Speakers and Recruitment workers may obtain to take with them, a "Blow-up"
photograph of blood transfusions for a wounded man in Fitzsimons.)
(Medical Officers may also take the picture and obtain from Lt. Col. John P. Harney at Fitzsimons, shell fragments to show
to audiences if they have so such souvenirs of their own.)