Download PDF A Surgeons Civil War: The Letters and Diary of Daniel M. Holt, M.D.

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Dead horses stinking—even the smell of rotting human flesh filtering through occasionally.

The most momentous medical advance during the Vietnam War was the use of air ambulances for helicopter evacuation. Development of the Bell UH-1 helicopter greatly decreased response times. It previously took hours from the time the soldier was wounded until he was treated.

A Surgeon's Civil War: The Letters and Diary of Daniel M. Holt, M.D.

But with the Bell UH-1 helicopter the average time was 35 minutes. Another remarkable innovation was the long range radio that could cover distances up to 5 miles. Use of radio sped up response time to injured soldiers and it took an average of 9 minutes for a medevac to be launched to the destination. Major increase in battlefield first-aid training and equipment leading to many more lives being saved a great improvement over the Vietnam War.

He remained conscious and had an adequate airway despite severe bleeding that could not be completely controlled at the scene with direct pressure. He was transported immediately to a combat support hospital CSH that was less than a mile away. In the resuscitation area, pressure that was applied at the wounding scene was maintained by medical personnel despite minimal bleeding.

He had sustained severe extremity and soft-tissue wounds, including a traumatic amputation of the right hand, a left arm radial artery injury with soft-tissue injury to the hand, a near amputation of the left leg, and severe injuries to the right leg. The patient underwent rapid resuscitation by the assembled trauma team, which included emergency room and critical care physicians, nurses, medics, surgeons, and anesthesia providers. He was intubated, a right subclavian central line was inserted, and 4 units of packed red blood cells PRBCs were rapidly transfused.

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The walking blood bank was activated immediately so that fresh whole blood would be available within 45 minutes. The patient was transported immediately to the operating room OR , where his resuscitation continued. An end femoral artery arterial line was placed because no other sites were immediately available.

The near amputation of the left leg was completed, requiring a hip disarticulation. A rapid laparotomy was done and a loop colostomy fashioned. The right arm stump was debrided, as was the soft-tissue injury to the left thenar eminence. The left radial artery, which now began to bleed profusely, was ligated after it was clear that the hand was adequately perfused by the ulnar circulation.

A Surgeon's Civil War: The Letters and Diary of Daniel M. Holt, M.D.

Wounds were dressed by sponges held in place by stapling expandable mesh dressing to the skin. He was taken to the intensive care unit ICU where warming and further resuscitation were continued. After a brief stopover, he was evacuated to a level V medical facility in the United States, where he arrived just 36 hours after leaving the CSH. After multiple surgical procedures and extensive rehabilitation, he was medically retired and is currently fully employed". Colonel Frederick Lough was twice deployed to Afghanistan where he performed hundreds of surgeries on the front lines of battlefields, saving many lives.

The story of importance of war doctors and nurses has been largely untold. Medicine has progressed greatly as you can see through our timeline of different wars. Medical innovations and better training has greatly improved the healthcare provided to our soldiers. Doctors and nurses have changed United States history by providing medical care to our soldiers when they need it the most. Without these war doctors and nurses the casualties for all of the wars would have been much higher. As you have seen, these healthcare professionals who devoted their lives to serving our country went through a lot and experienced horrific things.

These war doctors and nurses are not given the credit they deserve in United States history for everything they have done for our citizens. Hampton, Ellen.


Holt DM. Kennedy, Paul A. Holt, M. Daniel M. Holt, a successful country doctor in the upstate village of Newport, New York, accepted the position of assistant surgeon in the st New York Volunteers in August At age 42 when he was commissioned, he was the oldest member of the staff.

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But his experience served him well, as his regiment participated in nearly all the major campaigns in the eastern theater of the war - Crampton's Gap before Antietam, Fredericksburg, Salem Church, the Mine Run campaign, the Wilderness, Spotsylvania, Cold Harbor, Petersburg, the Shenandoah Valley campaign, and Appomattox.

In A Surgeon's Civil War, the educated and articulate Holt describes camp life, army politics, and the medical difficulties that he and his colleagues experienced. When most people think of Civil War surgery they envision a poor soldier being forcibly held down while his arm or leg is amputated without the benefit of anesthesia. This Hollywood concept of Civil War surgery is far from accurate.

After a successful public demonstration it became widely used in surgery.

A Surgeon's Civil War: The Letters & Diary of Daniel M. Holt, M.D.

Chloroform, which had been discovered in , was soon in common use as well. By the Civil War, the anesthetic qualities of chloroform and ether were well known and widely used. Chloroform was the preferred anesthetic since a smaller quantity was needed and its effect was rapid. It was administered gradually to avoid shock. Once the patient was affected the cone was removed.

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The average time needed for the administration of chloroform was nine minutes. Ether was used less frequently since more of the substance was needed to produce the desired effect and it took an average of seventeen minutes to work. The best method of administration was to use a folded towel or bell-shaped sponge which was large enough to cover the nose and mouth.