Innovation Born In Bloodshed

During the Battle of Belchite, Spanish doctors attached to the International Brigades noticed that casualties with severe facial injuries and fractures (of which there were an unusually high number, due to the activities of Nationalist snipers) were dying shortly after recieving first aid, while waiting on the stretcher for definitive treatment. The deaths were usually due to blood collecting in the airway, so they decided to change their practice and perform a new emergency procedure as an initial action: an incision was opened in the patient's throat, and kept open. This gave them the opportunity to suction the airway contents and rapidly restore respiration. the procedure became called a tracheostomy.

After this procedure, they stopped the bleeding and stabilized the patient, who could then wait to have his fractures reduced and debridement performed. This simple management sequence, resembling current methods of resuscitation, saved many lives during the subsequent battles of the Civil War and was adopted by Allied surgeons during the Second World War, yet many of the spanish surgeons who innovated the practice were to suffer heavy persecution in the war's aftermath, simply for having been healing the 'wrong side'.

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