Operating and anaesthetising these soldiers might expedite death by compromising the body’s defence mechanisms. Geoffrey Marshall was sent to a CCS to investigate the effects of anaesthesia on wounded soldiers.
He concluded that spinal anaesthesia, originally thought to minimise the effects of shock, was disastrous, and established that chloroform and ether should not be used as anaesthetics for very shocked patients, although ether would initially maintain the blood pressure. The only suitable anaesthetic for these patients was gas (nitrous oxide) with oxygen. For mildly shocked and resuscitated soldiers, ether and chloroform were acceptable.
For patients with abdominal injuries, Marshall recommended ether, given by Shipway’s warmed ether apparatus; for cases of penetrating injury of the chest or abdomen, he recommended chloroform.