Blood transfusion apparatus, United Kingdom, 1914-1918

It’s 1917, and you are a wounded soldier at a casualty clearing station on the Western Front. You are bleeding badly and going into shock. You are in danger of dying and urgently need blood – where’s the nearest blood bank? He’s right next to you. Your blood transfusion will come directly from another patient. Is it safe? It’s the best method available at the time, particularly if your surgeon is Lieutenant Geoffrey Keynes of the Royal Army Medical Corps. He designed and pioneered this portable blood transfusion kit, with a special device in the flask for regulating flow. Why didn’t Keynes use stored blood? It didn’t keep very well. It needed to be refrigerated – a difficult task in field hospitals, and it clotted into lumps unless an anticoagulant was added. While it became technically possible to do this during the First World War, the patient-to-patient method was still more widely used. Matching of blood groups was recommended, but there was not always time. The first blood banks stored O type blood – suitable for all recipients. But in the meantime, you were lucky to have reached a casualty clearing station, to take your chances with an emergency transfusion. And who better than with Lieutenant (later Sir) Geoffrey Keynes? In 1921 he co-founded London’s Blood Transfusion Service, and a year later published Britain’s first textbook on the subject.