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GCSE · EDEXCEL

EDX.WF.1 The Western Front, 1914-16: Trench Warfare, Wounds and the Chain of Evacuation

EDEXCEL 1HI0 · Calculators not allowed · about 60 minutes

Total Marks

Name: _______________________________ Date: ____ / ____ / ______

Answer ALL questions. Questions 13 and 14 refer to Source A and Source B. Write in full sentences for Questions 13, 14 and 15. You are advised to spend about 60 minutes on this pack.

Source A and Source B: Wounds and Evacuation on the Western Front, 1915

Source A and Source B were written for Revision Library as original, representative teaching material. Source A is an account in the style of a Royal Army Medical Corps stretcher-bearer's diary, written to represent the kind of first-hand experience described in verified historical accounts of the Western Front in 1915; it is not the testimony of a real, named individual, and no genuine wartime document has been reproduced or quoted. Source B is an illustrative table styled on historical research into casualty patterns on the Western Front; its figures are representative estimates for teaching purposes, not an authentic official record.

SOURCE A: from a diary written in the style of a Royal Army Medical Corps stretcher-bearer, describing a night near Ypres, 1915.

Third night now in the support trench, and the mud is worse than the shelling. Two men from B Company came down the communication trench just after dark, one with a shrapnel wound to the shoulder, the other gassed and coughing badly. We got the shoulder wound dressed and morphine given inside ten minutes; the gas case took longer, his eyes were closed and swollen, and we had to guide him the whole way on a rope tied between us, since he could not see the duckboards. The ground was so churned that the stretcher-bearers ahead of us went down twice, and it took near two hours to reach the Advanced Dressing Station, a journey that should take forty minutes on a good night. We are told a proper road is being laid for the ambulances, but for now it is stretchers and mud, all the way back.

SOURCE B: an illustrative table showing the estimated share of wounded soldiers treated at each stage of the chain of evacuation on the Western Front, 1915, and the typical treatment given there.

Stage of evacuation | Approximate share of wounded treated there | Typical treatment given

Regimental Aid Post | about 100% (all wounded passed through) | first aid, basic dressings, morphine for pain

Advanced Dressing Station | about 60% | further dressing, assessment, some minor treatment

Casualty Clearing Station | about 30% | emergency surgery, blood transfusion (from 1915, limited), sorting for further evacuation

Base Hospital | about 20% | longer-term treatment, recovery, or return to Britain for the most seriously wounded

Note: the percentages do not sum to 100 because many wounded soldiers were treated and then returned to duty at an earlier stage without needing to reach the next one.

Give the name used for the continuous line of trenches that ran from the North Sea coast to the Swiss border during the First World War.

(Total for Question 1 is 1 mark)

Name the organisation responsible for the medical treatment of wounded British soldiers on the Western Front.

(Total for Question 2 is 1 mark)

Name the first stage in the chain of evacuation, usually in or close to the front-line trench, where a Regimental Medical Officer gave immediate first aid.

(Total for Question 3 is 1 mark)

Name the second stage in the chain of evacuation, a short distance behind the front line, where wounds were dressed and casualties assessed.

(Total for Question 4 is 1 mark)

Name the stage in the chain of evacuation, further back than the Advanced Dressing Station, where wounded soldiers could receive emergency surgery.

(Total for Question 5 is 1 mark)

Name the final stage in the chain of evacuation, which provided longer-term treatment and was often located near the coast or a railway line.

(Total for Question 6 is 1 mark)

Name the poison gas first used by the German army against British and French troops at the Second Battle of Ypres in April 1915.

(Total for Question 7 is 1 mark)

Give one health problem caused by soldiers standing for long periods in cold, wet trench conditions.

(Total for Question 8 is 1 mark)

Name the medical term, then poorly understood, used to describe the psychological effects of the stress of trench warfare on soldiers.

(Total for Question 9 is 1 mark)

Give one reason why wounds received on the Western Front were especially likely to become infected.

(Total for Question 10 is 2 marks)

Describe two features of trench warfare on the Western Front, 1914-16.

(Total for Question 11 is 4 marks)

Give two reasons why evacuating wounded soldiers from the front line was often slow and difficult in 1914-16.

(Total for Question 12 is 4 marks)

How useful is Source A for an enquiry into the dangers faced by medical personnel on the Western Front in 1915? Explain your answer, using Source A and your own knowledge of the historical context.

(Total for Question 13 is 8 marks)

How could you use Source A and Source B to find out about the treatment of wounded soldiers on the Western Front, 1914-16? Explain your answer, using Source A, Source B and your own knowledge.

(Total for Question 14 is 8 marks)

Explain why the chain of evacuation was important to the survival of wounded soldiers on the Western Front, 1914-16.

(Total for Question 15 is 8 marks)

Name two methods used to transport wounded soldiers along the chain of evacuation on the Western Front, 1914-16.

(Total for Question 16 is 2 marks)

Give two dangers, other than enemy fire and poison gas, that made a stretcher-bearer's work especially difficult on the Western Front.

(Total for Question 17 is 2 marks)

Mark scheme · EDX.WF.1 The Western Front, 1914-16: Trench Warfare, Wounds and the Chain of Evacuation

Question 1

B1 the Western Front
Answer: The Western Front

Question 2

B1 the Royal Army Medical Corps (RAMC)
Answer: The Royal Army Medical Corps (RAMC)

Question 3

B1 the Regimental Aid Post (RAP)
Answer: Regimental Aid Post (RAP)

Question 4

B1 the Advanced Dressing Station (ADS)
Answer: Advanced Dressing Station (ADS)

Question 5

B1 the Casualty Clearing Station (CCS)
Answer: Casualty Clearing Station (CCS)

Question 6

B1 the Base Hospital
Answer: Base Hospital

Question 7

B1 chlorine gas
Answer: Chlorine gas

Question 8

B1 trench foot (accept frostbite)
Answer: Trench foot

Question 9

B1 shell shock
Answer: Shell shock

Question 10

B1 the heavily cultivated and manured farmland soil of Belgium and northern France carried high levels of bacteria
B1 which entered open wounds along with mud, clothing fragments and shrapnel, increasing the risk of infections such as gas gangrene and tetanus
Answer: Heavily manured farmland soil carried bacteria (e.g. causing gas gangrene and tetanus) into wounds along with mud and shrapnel.

Question 11

B1 feature 1 identified, e.g. lines of trenches (front line, support and reserve) linked by communication trenches
B1 supporting detail for feature 1, e.g. the gap between opposing front lines, no man's land, was covered by barbed wire and machine-gun fire
B1 feature 2 identified, e.g. trenches were often flooded and muddy, especially in winter
B1 supporting detail for feature 2, e.g. duckboards were laid along the base of trenches to try to keep soldiers' feet out of standing water
Answer: Any two features, e.g. the linked system of front/support/reserve trenches separated by no man's land, and the flooded, muddy conditions duckboards tried to address.

Question 12

B2 narrow, muddy and waterlogged communication trenches made it physically hard for stretcher-bearers to carry a casualty quickly and safely
B2 the front line and support trenches were often under observation or fire, so casualties frequently had to be moved at night, which was slower and more dangerous than moving in daylight
Answer: Narrow, muddy communication trenches, and the need to move casualties mainly at night to avoid enemy fire.

Question 13

Level 1 (1-2): Makes a simple comment on the content of Source A, with little or no reference to its nature, origin or purpose, or to own knowledge.
Level 2 (3-4): Describes the content of Source A and begins to comment on its value, with limited reference to its nature, origin, purpose or own knowledge.
Level 3 (5-6): Analyses the content and the nature/origin/purpose of Source A, using own knowledge to support a developing judgement about how useful it is for the given enquiry.
Level 4 (7-8): Analyses the content and the nature/origin/purpose of Source A in a well-supported and convincing way, using precise own knowledge to reach a sustained judgement about how useful it is for the given enquiry, considering its limitations.
Indicative content:
- Content: Source A shows RAMC personnel exposed to danger while moving through mud and darkness to evacuate wounded, including a slow, exhausting journey to the Advanced Dressing Station.
- Content: it shows the specific danger of treating and guiding a gassed casualty, reflecting the introduction of chemical weapons on the Western Front from April 1915.
- Nature/origin/purpose: as an account written to represent an RAMC stretcher-bearer's experience, it reflects the kind of first-hand testimony historians use, but because it is written for this pack rather than a genuine wartime diary, it cannot be used as direct primary evidence for a specific date, unit or individual.
- Own knowledge: contextual knowledge of the chain of evacuation, poor trench conditions, and the use of chlorine gas from April 1915 can be used to assess whether the account is consistent with what is known from verified historical accounts of the period.
- A full answer weighs the source's plausible, typical content, consistent with verified historical knowledge of trench conditions and evacuation difficulties, against its limitations as illustrative rather than archival material, before reaching a judgement on its usefulness for the stated enquiry.

Question 14

Level 1 (1-2): Makes a simple comment on the content of one source, with little or no reference to using the sources together or to own knowledge.
Level 2 (3-4): Describes the content of both sources and suggests, in general terms, what each could be used to find out.
Level 3 (5-6): Explains what Source A and Source B could each be used to find out, and begins to explain how they could be used together, supported by own knowledge.
Level 4 (7-8): Explains clearly and convincingly what Source A and Source B could be used to find out both separately and together, supported throughout by precise own knowledge of the historical context.
Indicative content:
- Source A shows what happened to individual casualties at the start of the chain of evacuation (first aid and morphine near the front line, then a difficult journey to the Advanced Dressing Station), which could be used to investigate the practical difficulties of evacuation.
- Source B shows the overall pattern of where wounded soldiers were treated across the whole chain of evacuation, which could be used to investigate how casualties were distributed between the different stages.
- Used together, Source A's individual case and Source B's overall statistics could be used to investigate how far one soldier's experience of a slow, difficult evacuation was typical of the wider pattern described in Source B.
- Own knowledge could be used to check both sources against what is known about the RAMC's organisation of the chain of evacuation (Regimental Aid Post, Advanced Dressing Station, Casualty Clearing Station, Base Hospital) and about specific problems such as difficult terrain and the use of poison gas from 1915.
- A full answer explains what each source could be used to investigate, and how using them together allows a more complete enquiry than either source alone, while noting that both are illustrative rather than genuine archival material.

Question 15

Level 1 (1-2): Identifies one or two general reasons why the chain of evacuation mattered, with little or no supporting detail or explanation.
Level 2 (3-4): Identifies and begins to explain one reason, supported by accurate detail.
Level 3 (5-6): Explains two reasons why the chain of evacuation was important, each supported by accurate and relevant detail.
Level 4 (7-8): Explains two or more reasons in a well-developed, logically structured way, supported throughout by precise and accurate detail, showing how the reasons connect.
Indicative content:
- The Regimental Aid Post gave rapid first aid close to the front line, which could stop life-threatening bleeding or shock in the crucial first minutes after a soldier was wounded.
- Moving a casualty stage by stage (Regimental Aid Post to Advanced Dressing Station to Casualty Clearing Station to Base Hospital) meant only the most seriously wounded had to make the longer, more dangerous journeys further back, saving time and resources.
- Casualty Clearing Stations, positioned close enough to the front for urgent surgery but further back than the trenches, allowed life-saving operations, and from 1915 limited blood transfusion, to be carried out before infection could set in.
- Without an organised chain, wounded soldiers would have had to be carried much further, over dangerous and difficult ground, before receiving any treatment, greatly increasing the risk of death from blood loss, shock or infection.
- The system allowed medical resources such as surgeons, blood and equipment to be concentrated at the Casualty Clearing Station and Base Hospital stages, rather than being spread thinly across the front line, making treatment more effective overall.

Question 16

B1 stretcher-bearers carrying casualties by hand over difficult, muddy ground close to the front line
B1 horse-drawn or early motor ambulances, used on better roads further back from the front line
Answer: Stretcher-bearers (close to the front) and horse-drawn or motor ambulances (further back, on better roads).

Question 17

B1 deep mud and waterlogged ground, which made stretchers heavy and slow to carry, and could cause bearers to fall
B1 damaged or narrow communication trenches, which restricted movement and often forced evacuation to happen at night
Answer: Deep mud/waterlogged ground, and damaged, narrow communication trenches (often meaning night-time movement).

The Western Front, 1914-16: Trench Warfare, Wounds and the Chain of Evacuation - Worksheets, Questions and Revision