Surgeons acknowledged that nitrous oxide-oxygen anesthesia gave less satisfactory muscular relaxation than either ether or chloroform, required expensive and cumbersome apparatus for its transportation and administration, cost more than other anesthetics, \u00a0was technically the most difficult to administer of all the anesthetics then available, and was dangerous in inexperienced hands. However, Crile thought these disadvantages \u00a0to be outweighed by its advantages. \u00a0Nitrous oxide\u00a0proved\u00a0quick in action and pleasant to take; recovery occurred\u00a0immediately, without nausea; food could be taken soon after recovery; patients could be transported \u00a0soon after recovery; less nursing care was required; such complications as bronchitis, pneumonia, and nephritis did not follow it.\u00a0 In his shock research, Crile experimented with nitrous oxide and concluded that the addition of oxygen would give better protection to the central nervous system against the shock of surgery than ether or chloroform.<\/p>\n
Crile enlisted Agatha Hodgins to administer nitrous oxide anesthesia during the Lakeside Unit\u2019s three month term.\u00a0\u00a0 \u201cOne morning in 1908 while making rounds, I drew Miss Hodgins aside and presented to her what amounted to an annunciation.\u00a0 She had received no warning about the plan to make her my special anesthetist but she told me promptly that she would undertake it if I would remember always that she was giving her best\u2026 and I never had any occasion to be disappointed in her work.\u201d Hodgins perfected the administration of nitrous oxide-oxygen.<\/p>\n
The cases seen by the Unit fell within several broad categories: gunshot wounds, shrapnel and shell wounds, fractures, frostbite and trench foot.\u00a0 At a distance from the front, the American Ambulance received severely wounded soldiers requiring long convalescence.\u00a0 Injured soldiers who reached the hospital had an excellent chance of recovery.\u00a0 The exceptions were patients with abdominal wounds, most of whom died.\u00a0 Tetanus and gas gangrene were relatively rare occurrences. \u00a0Of \u00a0the 1200 cases admitted up to March 1, 1915, there were only four cases of tetanus and severe gas gangrene. Chest wounds usually did very well.\u00a0 Although the overall mortality rate was high, those who survived recovered well.<\/p>\n
It was noted in reports submitted by American Ambulance personnel that trench warfare was generating an increase in the number of facial and head wounds. Dr. Hayes, \u00a0Chief Dental Surgeon at the American Ambulance, worked closely with the Lakeside Unit. In his 1915 annual report, Dr. Hayes distinguishes the American Ambulance as being the first military hospital to have a dental surgeon on its medical board. Initially, the dental department spent most of its time examining the teeth of patients to provide general dental hygiene.\u00a0 As these cases of \u201cfractured jaw\u201d \u00a0were brought in, a new branch of dental surgery and dental orthopedics came into existence.<\/p>\n\n\t\t\t