Birmingham Accident Hospital
Encyclopedia
Birmingham Accident Hospital formerly known as Birmingham Accident Hospital and Rehabilitation Centre was established in April 1941 as Birmingham's response to two reports, the British Medical Association's Committee on Fractures (1935) and the Interdepartmental Committee (1939) on the Rehabilitation of Persons injured by Accidents. Both organisations recommended specialist treatment and rehabilitation facities. The hospital, which has a strong claim to be the World's first Trauma Center
, used the existing buildings of Queen's Hospital, a former Teaching Hospital
in Bath Row, Birmingham
, England, in the United Kingdom.
It changed its name to Birmingham Accident Hospital in 1974 and closed due to budget cuts around 1995. A listed building it is now part of Queens Hospital Close, a student accommodation complex.
A Blue plaque
commemorates its former role.
laid the foundation stone of the University of Birmingham Medical School
's new teaching hospital on 18 June 1840, the building being completed the following year at a cost of £
8,746. Henry Pepys
, the Anglican
Lord Bishop of Worcester
presided over the ceremony formally opening the 70-bed hospital.
The hospital expanded rapidly. By 1845 separate wards were added containing 28 beds for infectious and contagious disease cases, raising hospital capacity to 98. In 1867, adjacent grounds were purchased, and in 1871, Lord Leigh laid the foundation stone for a new outpatient department to the strains of a hymn written for the occasion by the Rev. Charles Kingsley
and sung by 1,000 child choristers from the Birmingham Schools Choral Union.
In 1875, Queen's became a free hospital, abandoning the previous system whereby the hospital's financial supporters issued "subscriber's tickets" to authorize treatment. A one shilling
admission fee was charged but could be waived.
In 1877, 16,117 patients were treated at Queen's, but by 1908, the patient count had more than doubled to 39,483, composed of 2,685 inpatients and 36,708 outpatients. Average annual expenditure from 1909 to 1911 was £14,729, against average receipts £10,778 leaving an average annual deficit of £3,951, covered by endowments and donations.
In 1900, William Humble Ward, 2nd Earl of Dudley
, took over the presidency of the hospital. A new block opened in 1908 with three stories of wards as well as a roof ward for six patients, the first of its kind in Europe. The integrated nursing home's capacity increased from 34 to 74 beds, and the hospital itself now had 60 medical and 118 surgical beds, totalling 178. Bed count and services provided continued to expand until closure.
opened. The outbreak of war however delayed the planned partial redeployment of the building as an accident hospital. In 1941, the opportunity was taken for Birmingham to address the problems of delay in treatment of serious injuries. Accidents in Birmingham had risen by 40% as inexperienced workers entered wartime factories. Birmingham Accident Hospital and Rehabilitation Centre as it became, was thus the last voluntary hospital in the country and its specified objectives included prevention of industrial accidents. Its Surgeon in Chief and clinical director was Professor William Gissane.
On 14 August 1944 the President of the Hospital, the Lord Mayor of Birmingham welcomed the Minister of Health Sir Henry Willink at the opening of a new reception area and Outpatients department. Sir Henry said the Accident Hospital experiment was being closely watched and was likely to have a permanent future in hospital services. Referring to the Beveridge report and his own 1944 White paper, he said he recognised the close cooperation between the University, the city authorities and the hospital and hoped that this spirit of cooperation would pervade the future National Health Service
. The Parliamentary secretary to the Minister of Labour George Tomlinson
described rehabilitation as "one of the great social advances which has emerged from this war". He added that only 18,000 of the 200,000 disabled and unemployed remained so.
In 1941 Sir Ashley Miles, studied war wounds as part time director of the MRC at the Accident hospital.
and two years later, Leonard Colebrook
, an expert on the earliest antibiotic Prontosil
, active against streptococcus
, moved with his burns unit from Glasgow Royal Infirmary
. A joint project led to the development of MRC cream no 9, the main burns treatment at that time.
Colebrook established the practice of placing the patients in a near sterile environment.
His political campaigning against unguarded fires and inflammable children's nightwear led to the Heating Appliances and Fireguards Act 1952.
In 1949 Edward Lowbury
succeeded Colebrook as Head of Bacteriology. In the 60’s and 70’s as one of the foremost researchers in hospital infection particularly in the prevention of burns infection, the problems of antibiotic resistance and skin disinfection, he lectured around the world.
Clinical trials confirmed Colebrooke’s work showing that specialist positively pressurised dressing rooms reduced infections.
With John Babb he proved that a specialised filter system could remove bacteria from an airstream and retain them either reducing infection risk or allowing an already infected patient to be treated in an open ward.
He documented treatment of infections with Pseudomonas aeruginosa
noting that the development of carbenicillin
resistance
used a single mechanism which conferred protection against a range of antibiotics. He further showed that overuse of a new antibiotic led to increased staphylococcus resistance, and that a subsequent reduction in use reversed the effect. His work with Rod Jones contributed to the development of a pseudomonas vaccine.
With Harold Lilly he developed tests for effectiveness of hand washes before alcohol became the norm in 1974. These tests were still the basis for European standards when he died in 2007.
He worked on topical
antibacterial compounds with surgeons Douglas Jackson and Jack Cason eventually leading to topical silver which was still in use at his death.
that covered bacteriology
, haematology, biochemistry
, histology
,
and morbid anatomy.
Though his best known work was in venous thrombosis
and pulmonary embolism
, fat embolism
, and the healing of fractures, he was to become an “outstanding pathologist, particularly in accident surgery”.
His controversial 1959 paper on thromboembolism after fracture of the hip in old people written in conjunction with Gallagher which found that
fatal pulmonary embolism
might occur 30 days or more after surgery for hip fracture
triggered work by other researchers and revolutionised the profession's attitude to preventing, diagnosing, and
treating the condition.
Dr Sevitt died in September 1988.
, UK road injuries were increasing rapidly. Motorcyclists alone accounted for over 1000 UK deaths
compared to the 2008 road user total of just 2645.
"Research work at the Birmingham Accident Hospital improved the treatment of injury immeasurably." Alan Ruscoe Clarke studied haemorrhagic shock for different types of injury and showed that the lethal collapse of blood volume was caused by swellings around a fracture or burn and not by blood becoming temporarily static in the capillaries. Immediate transfusion and surgery reversed or delayed the "illness of trauma" and was essential.
In his 1957 lecture to the St. John Ambulance Brigade Surgeons' Conference in Harrogate Ruscoe Clarke described the old theory of shock and why it failed.
Despite the success of James Blundell
with blood transfusions, saline solution was the standard substitute from 1868 to 1916.
Surgeon Ernest Cowell, writing in The British Official History of the Great War
described the results of saline solution at the Battle of the Somme as "most disappointing". Canadian surgeons recommended whole blood transfusions
though volumes used were small -even the largest transfusions used were only about a litre.
Treatment of shock from 1919 was based on observations of Cowell and Walter Bradford Cannon
. However plasma volume measurements suggested more blood was disappearing from the circulation than could be accounted for. It wasn’t in the veins or the arteries so it was assumed to be temporarily immobilised throughout the capillary system. Treatment was therefore aimed at encouraging blood to return to the circulation by heating the patient, rubbing the limbs –and providing hot sweet tea intended to increase circulation volume.
The large transfusions made possible by the development of blood banks in the 1930s transformed many patients. In 1940 Alfred Blalock
proposed that shock was caused by bleeding, a view accepted by various authorities by 1946. The war injuries study of Grant and Reeve published 1951 recommended early transfusions for large wounds and suggested existing theories were inadequate.
Clarke further described how observations at the Birmingham Accident Hospital on peacetime accident victims confirmed Grant and Reeve’s work and provided evidence to reject the old capillary theory. Their work showed that blood was missing from the circulation just as often in closed fractures as in open wounds, that the blood lost appeared proportional to the severity of the wound and that the swelling of the injury frequently corresponded to the volume of blood lost. Blood loss from open wounds similarly matched blood lost from circulation.
Blood losses had been consistently underestimated in the past but the provision of large transfusions during the Korean War had saved people with injuries who would not otherwise have survived.
He recommended that where significant blood loss had occurred, even over an extended period of time, the patient should be transferred to expert medical care and receive an immediate transfusion. There was no place for hot tea, heat treatment or massage which delayed proper treatment.
at a time before seat belts were mandatory. Gissane believed risks of accidents occurring were lower on motorways but the consequences were more serious.
A further study of "all deaths from road accidents in certain areas and periods" suggested lorries were the main cause of car fatalities on Motorways and Link roads and that seatbelts provided little protection available for the car occupants.
UK lorries are now fitted with an impact absorbing rear barrier, meeting one of the recommendations.
Investigation techniques included interviews with police, hospitals, survivors and coroners to study ways in which vehicle design could be changed to avoid accidents in the first place and to mitigate the injuries caused.
, the worst terrorist attack on the mainland until 2005 occurred within a mile of the hospital. Taxi cabs and all available ambulances ferried victims to either the Accident hospital or to the Birmingham General hospital
.
Trauma center
A trauma center is a hospital equipped to provide comprehensive emergency medical services to patients suffering traumatic injuries. Trauma centers grew into existence out of the realization that traumatic injury is a disease process unto itself requiring specialized and experienced...
, used the existing buildings of Queen's Hospital, a former Teaching Hospital
Teaching hospital
A teaching hospital is a hospital that provides clinical education and training to future and current doctors, nurses, and other health professionals, in addition to delivering medical care to patients...
in Bath Row, Birmingham
Birmingham
Birmingham is a city and metropolitan borough in the West Midlands of England. It is the most populous British city outside the capital London, with a population of 1,036,900 , and lies at the heart of the West Midlands conurbation, the second most populous urban area in the United Kingdom with a...
, England, in the United Kingdom.
It changed its name to Birmingham Accident Hospital in 1974 and closed due to budget cuts around 1995. A listed building it is now part of Queens Hospital Close, a student accommodation complex.
A Blue plaque
Blue plaque
A blue plaque is a permanent sign installed in a public place to commemorate a link between that location and a famous person or event, serving as a historical marker....
commemorates its former role.
The Queen's Hospital (Birmingham)
Earl HoweRichard Curzon-Howe, 1st Earl Howe
Richard William Penn Curzon-Howe, 1st Earl Howe, GCH, PC was a British peer and courtier.Curzon was the third son of Hon...
laid the foundation stone of the University of Birmingham Medical School
University of Birmingham Medical School
The University of Birmingham Medical School is one of Britain's largest and oldest medical schools with over 400 Medics graduating each year. It is based at the University of Birmingham in Edgbaston, Birmingham, England...
's new teaching hospital on 18 June 1840, the building being completed the following year at a cost of £
Pound sterling
The pound sterling , commonly called the pound, is the official currency of the United Kingdom, its Crown Dependencies and the British Overseas Territories of South Georgia and the South Sandwich Islands, British Antarctic Territory and Tristan da Cunha. It is subdivided into 100 pence...
8,746. Henry Pepys
Henry Pepys
Henry Pepys was a Church of England Bishop of Worcester.-Biography:Pepys was born in Wimpole Street, London, the son of Sir William Weller Pepys , a master in chancery, who was descended from John Pepys, of Cottenham, Cambridgeshire, the great-grandfather of Samuel Pepys the diarist...
, the Anglican
Church of England
The Church of England is the officially established Christian church in England and the Mother Church of the worldwide Anglican Communion. The church considers itself within the tradition of Western Christianity and dates its formal establishment principally to the mission to England by St...
Lord Bishop of Worcester
Bishop of Worcester
The Bishop of Worcester is the Ordinary of the Church of England Diocese of Worcester in the Province of Canterbury, England. He is the head of the Diocese of Worcester in the Province of Canterbury...
presided over the ceremony formally opening the 70-bed hospital.
The hospital expanded rapidly. By 1845 separate wards were added containing 28 beds for infectious and contagious disease cases, raising hospital capacity to 98. In 1867, adjacent grounds were purchased, and in 1871, Lord Leigh laid the foundation stone for a new outpatient department to the strains of a hymn written for the occasion by the Rev. Charles Kingsley
Charles Kingsley
Charles Kingsley was an English priest of the Church of England, university professor, historian and novelist, particularly associated with the West Country and northeast Hampshire.-Life and character:...
and sung by 1,000 child choristers from the Birmingham Schools Choral Union.
In 1875, Queen's became a free hospital, abandoning the previous system whereby the hospital's financial supporters issued "subscriber's tickets" to authorize treatment. A one shilling
Shilling
The shilling is a unit of currency used in some current and former British Commonwealth countries. The word shilling comes from scilling, an accounting term that dates back to Anglo-Saxon times where it was deemed to be the value of a cow in Kent or a sheep elsewhere. The word is thought to derive...
admission fee was charged but could be waived.
In 1877, 16,117 patients were treated at Queen's, but by 1908, the patient count had more than doubled to 39,483, composed of 2,685 inpatients and 36,708 outpatients. Average annual expenditure from 1909 to 1911 was £14,729, against average receipts £10,778 leaving an average annual deficit of £3,951, covered by endowments and donations.
In 1900, William Humble Ward, 2nd Earl of Dudley
Earl of Dudley
Earl of Dudley, of Dudley Castle in the County of Stafford, is a title that has been created twice in the Peerage of the United Kingdom, both times for members of the Ward family. This family descends from Sir Humble Ward, the son of a wealthy goldsmith and jeweller to King Charles I...
, took over the presidency of the hospital. A new block opened in 1908 with three stories of wards as well as a roof ward for six patients, the first of its kind in Europe. The integrated nursing home's capacity increased from 34 to 74 beds, and the hospital itself now had 60 medical and 118 surgical beds, totalling 178. Bed count and services provided continued to expand until closure.
Birmingham Accident Hospital and Rehabilitation Centre
Queen's remained a teaching hospital until the Queen Elizabeth Hospital, BirminghamQueen Elizabeth Hospital, Birmingham
The Queen Elizabeth Hospital Birmingham is an NHS hospital in the Edgbaston area of Birmingham, situated very close to the University of Birmingham. The hospital, which cost £545 million to construct, opened in June 2010 replacing the previous Queen Elizabeth Hospital and Selly Oak Hospital...
opened. The outbreak of war however delayed the planned partial redeployment of the building as an accident hospital. In 1941, the opportunity was taken for Birmingham to address the problems of delay in treatment of serious injuries. Accidents in Birmingham had risen by 40% as inexperienced workers entered wartime factories. Birmingham Accident Hospital and Rehabilitation Centre as it became, was thus the last voluntary hospital in the country and its specified objectives included prevention of industrial accidents. Its Surgeon in Chief and clinical director was Professor William Gissane.
On 14 August 1944 the President of the Hospital, the Lord Mayor of Birmingham welcomed the Minister of Health Sir Henry Willink at the opening of a new reception area and Outpatients department. Sir Henry said the Accident Hospital experiment was being closely watched and was likely to have a permanent future in hospital services. Referring to the Beveridge report and his own 1944 White paper, he said he recognised the close cooperation between the University, the city authorities and the hospital and hoped that this spirit of cooperation would pervade the future National Health Service
National Health Service
The National Health Service is the shared name of three of the four publicly funded healthcare systems in the United Kingdom. They provide a comprehensive range of health services, the vast majority of which are free at the point of use to residents of the United Kingdom...
. The Parliamentary secretary to the Minister of Labour George Tomlinson
George Tomlinson
George Tomlinson was a British Labour Party politician.Born in Rishton, Lancashire, he was a conscientious objector in the First World War, and worked on the land....
described rehabilitation as "one of the great social advances which has emerged from this war". He added that only 18,000 of the 200,000 disabled and unemployed remained so.
Burns unit and MRC.
Whilst infection was known in the 19th century as a dangerous complication in severe burns, until the 1950s its significance was regarded as secondary. Only once treatment for shock was available did it become recognised as the main cause of death. Whilst initially a burn is likely to be sterile, it will quickly become colonised from external sources, usually other patients in the same ward. Prevention of cross infection was therefore a key objective.In 1941 Sir Ashley Miles, studied war wounds as part time director of the MRC at the Accident hospital.
and two years later, Leonard Colebrook
Leonard Colebrook
Leonard Colebrook FRS was an English physician and Bacteriologistwho in 1935 showed Prontosil was effective against haemolytic streptococcus in childbirthand hence a cure for puerperal fever...
, an expert on the earliest antibiotic Prontosil
Prontosil
Prontosil, the first commercially available antibacterial antibiotic , was developed by a research team at the Bayer Laboratories of the IG Farben conglomerate in Germany...
, active against streptococcus
Streptococcus
Streptococcus is a genus of spherical Gram-positive bacteria belonging to the phylum Firmicutes and the lactic acid bacteria group. Cellular division occurs along a single axis in these bacteria, and thus they grow in chains or pairs, hence the name — from Greek στρεπτος streptos, meaning...
, moved with his burns unit from Glasgow Royal Infirmary
Glasgow Royal Infirmary
The Glasgow Royal Infirmary is a large teaching hospital, operated by NHS Greater Glasgow and Clyde,. With a capacity of around 1000 beds, the hospital campus covers an area of around 20 acres, situated on the north-eastern edge of the city centre of Glasgow, Scotland.-History:Designed by Robert...
. A joint project led to the development of MRC cream no 9, the main burns treatment at that time.
Colebrook established the practice of placing the patients in a near sterile environment.
His political campaigning against unguarded fires and inflammable children's nightwear led to the Heating Appliances and Fireguards Act 1952.
In 1949 Edward Lowbury
Edward Lowbury
Edward Joseph Lister Lowbury was a pioneering and innovative English medical bacteriologist and pathologist, and also a published poet.-Life:...
succeeded Colebrook as Head of Bacteriology. In the 60’s and 70’s as one of the foremost researchers in hospital infection particularly in the prevention of burns infection, the problems of antibiotic resistance and skin disinfection, he lectured around the world.
Clinical trials confirmed Colebrooke’s work showing that specialist positively pressurised dressing rooms reduced infections.
With John Babb he proved that a specialised filter system could remove bacteria from an airstream and retain them either reducing infection risk or allowing an already infected patient to be treated in an open ward.
He documented treatment of infections with Pseudomonas aeruginosa
Pseudomonas aeruginosa
Pseudomonas aeruginosa is a common bacterium that can cause disease in animals, including humans. It is found in soil, water, skin flora, and most man-made environments throughout the world. It thrives not only in normal atmospheres, but also in hypoxic atmospheres, and has, thus, colonized many...
noting that the development of carbenicillin
Carbenicillin
Carbenicillin is a bacteriolytic antibiotic belonging to the carboxypenicillin subgroup of the penicillins. It was discovered by scientists at Beecham and marketed as Pyopen. It has Gram-negative coverage which includes Pseudomonas aeruginosa but limited Gram-positive coverage...
resistance
Antibiotic resistance
Antibiotic resistance is a type of drug resistance where a microorganism is able to survive exposure to an antibiotic. While a spontaneous or induced genetic mutation in bacteria may confer resistance to antimicrobial drugs, genes that confer resistance can be transferred between bacteria in a...
used a single mechanism which conferred protection against a range of antibiotics. He further showed that overuse of a new antibiotic led to increased staphylococcus resistance, and that a subsequent reduction in use reversed the effect. His work with Rod Jones contributed to the development of a pseudomonas vaccine.
With Harold Lilly he developed tests for effectiveness of hand washes before alcohol became the norm in 1974. These tests were still the basis for European standards when he died in 2007.
He worked on topical
Topical
In medicine, a topical medication is applied to body surfaces such as the skin or mucous membranes such as the vagina, anus, throat, eyes and ears.Many topical medications are epicutaneous, meaning that they are applied directly to the skin...
antibacterial compounds with surgeons Douglas Jackson and Jack Cason eventually leading to topical silver which was still in use at his death.
Dr Simon Sevitt and Pathology
In 1947, Dr Simon Sevitt set up a pathology departmentPathology
Pathology is the precise study and diagnosis of disease. The word pathology is from Ancient Greek , pathos, "feeling, suffering"; and , -logia, "the study of". Pathologization, to pathologize, refers to the process of defining a condition or behavior as pathological, e.g. pathological gambling....
that covered bacteriology
Bacteriology
Bacteriology is the study of bacteria. This subdivision of microbiology involves the identification, classification, and characterization of bacterial species...
, haematology, biochemistry
Biochemistry
Biochemistry, sometimes called biological chemistry, is the study of chemical processes in living organisms, including, but not limited to, living matter. Biochemistry governs all living organisms and living processes...
, histology
Histology
Histology is the study of the microscopic anatomy of cells and tissues of plants and animals. It is performed by examining cells and tissues commonly by sectioning and staining; followed by examination under a light microscope or electron microscope...
,
and morbid anatomy.
Though his best known work was in venous thrombosis
Venous thrombosis
A venous thrombosis is a blood clot that forms within a vein. A venous thrombosis is a blood clot that forms within a vein. A venous thrombosis is a blood clot that forms within a vein. (Thrombosis is a medical term for blood clotting (Haemostasis) occurring in the wrong place, i.e...
and pulmonary embolism
Pulmonary embolism
Pulmonary embolism is a blockage of the main artery of the lung or one of its branches by a substance that has travelled from elsewhere in the body through the bloodstream . Usually this is due to embolism of a thrombus from the deep veins in the legs, a process termed venous thromboembolism...
, fat embolism
Fat embolism
A fat embolism is a type of embolism that is often caused by physical trauma such as fracture of long bones, soft tissue trauma and burns.-Presentation:...
, and the healing of fractures, he was to become an “outstanding pathologist, particularly in accident surgery”.
His controversial 1959 paper on thromboembolism after fracture of the hip in old people written in conjunction with Gallagher which found that
fatal pulmonary embolism
Pulmonary embolism
Pulmonary embolism is a blockage of the main artery of the lung or one of its branches by a substance that has travelled from elsewhere in the body through the bloodstream . Usually this is due to embolism of a thrombus from the deep veins in the legs, a process termed venous thromboembolism...
might occur 30 days or more after surgery for hip fracture
triggered work by other researchers and revolutionised the profession's attitude to preventing, diagnosing, and
treating the condition.
Dr Sevitt died in September 1988.
Ruscoe Clarke and the Treatment of Trauma.
By 1954, before the introduction of crash helmetsMotorcycle helmet
A motorcycle helmet is a type of protective headgear used by motorcycle riders. The primary goal of a motorcycle helmet is motorcycle safety - to protect the rider's head during impact, thus preventing or reducing head injury or saving the rider's life...
, UK road injuries were increasing rapidly. Motorcyclists alone accounted for over 1000 UK deaths
compared to the 2008 road user total of just 2645.
"Research work at the Birmingham Accident Hospital improved the treatment of injury immeasurably." Alan Ruscoe Clarke studied haemorrhagic shock for different types of injury and showed that the lethal collapse of blood volume was caused by swellings around a fracture or burn and not by blood becoming temporarily static in the capillaries. Immediate transfusion and surgery reversed or delayed the "illness of trauma" and was essential.
In his 1957 lecture to the St. John Ambulance Brigade Surgeons' Conference in Harrogate Ruscoe Clarke described the old theory of shock and why it failed.
Despite the success of James Blundell
James Blundell (physician)
James Blundell English obstetrician who performed the first successful transfusion of blood to a patient for treatment of a haemorrhage.-Early years:...
with blood transfusions, saline solution was the standard substitute from 1868 to 1916.
Surgeon Ernest Cowell, writing in The British Official History of the Great War
History of the Great War
The History of the Great War is a series of 28 volumes covering the military operations of the British Army during the First World War. The full title is the History of the Great War Based on Official Documents but the series is usually referred to as the British Official History...
described the results of saline solution at the Battle of the Somme as "most disappointing". Canadian surgeons recommended whole blood transfusions
though volumes used were small -even the largest transfusions used were only about a litre.
Treatment of shock from 1919 was based on observations of Cowell and Walter Bradford Cannon
Walter Bradford Cannon
Walter Bradford Cannon, M.D. was an American physiologist, professor and chairman of the Department of Physiology at Harvard Medical School. He coined the term fight or flight response, and he expanded on Claude Bernard's concept of homeostasis...
. However plasma volume measurements suggested more blood was disappearing from the circulation than could be accounted for. It wasn’t in the veins or the arteries so it was assumed to be temporarily immobilised throughout the capillary system. Treatment was therefore aimed at encouraging blood to return to the circulation by heating the patient, rubbing the limbs –and providing hot sweet tea intended to increase circulation volume.
The large transfusions made possible by the development of blood banks in the 1930s transformed many patients. In 1940 Alfred Blalock
Alfred Blalock
Alfred Blalock was a 20th-century American surgeon most noted for his research on the medical condition of shock and the development of the Blalock-Taussig Shunt, surgical relief of the cyanosis from Tetralogy of Fallot—known commonly as the blue baby syndrome—with Vivien Thomas and pediatric...
proposed that shock was caused by bleeding, a view accepted by various authorities by 1946. The war injuries study of Grant and Reeve published 1951 recommended early transfusions for large wounds and suggested existing theories were inadequate.
Clarke further described how observations at the Birmingham Accident Hospital on peacetime accident victims confirmed Grant and Reeve’s work and provided evidence to reject the old capillary theory. Their work showed that blood was missing from the circulation just as often in closed fractures as in open wounds, that the blood lost appeared proportional to the severity of the wound and that the swelling of the injury frequently corresponded to the volume of blood lost. Blood loss from open wounds similarly matched blood lost from circulation.
Blood losses had been consistently underestimated in the past but the provision of large transfusions during the Korean War had saved people with injuries who would not otherwise have survived.
He recommended that where significant blood loss had occurred, even over an extended period of time, the patient should be transferred to expert medical care and receive an immediate transfusion. There was no place for hot tea, heat treatment or massage which delayed proper treatment.
Road Injuries Research Group
In 1960 Professor Gissane became Honorary director of the Road Injuries Research Group. This investigated and analysed accidents on the newly opened M1 MotorwayM1 motorway
The M1 is a north–south motorway in England primarily connecting London to Leeds, where it joins the A1 near Aberford. While the M1 is considered to be the first inter-urban motorway to be completed in the United Kingdom, the first road to be built to motorway standard in the country was the...
at a time before seat belts were mandatory. Gissane believed risks of accidents occurring were lower on motorways but the consequences were more serious.
A further study of "all deaths from road accidents in certain areas and periods" suggested lorries were the main cause of car fatalities on Motorways and Link roads and that seatbelts provided little protection available for the car occupants.
UK lorries are now fitted with an impact absorbing rear barrier, meeting one of the recommendations.
Investigation techniques included interviews with police, hospitals, survivors and coroners to study ways in which vehicle design could be changed to avoid accidents in the first place and to mitigate the injuries caused.
Birmingham Bombings 1974
The Birmingham Pub BombingsBirmingham pub bombings
The Birmingham pub bombings occurred on 21 November 1974 in Birmingham, England. The explosions killed 21 people and injured 182. The devices were placed in two central Birmingham pubs – the Mulberry Bush and the Tavern in the Town . Although warnings were sent, the pubs were not evacuated in time...
, the worst terrorist attack on the mainland until 2005 occurred within a mile of the hospital. Taxi cabs and all available ambulances ferried victims to either the Accident hospital or to the Birmingham General hospital
Birmingham Children's Hospital
The Birmingham Children's Hospital is a children's hospital located in Birmingham, England.It provides general and emergency health care services to children in Birmingham, the West Midlands and beyond. It specialises in liver transplantation, cardiac, and neonatal surgery...
.