Sep 25, 2018

The Golden Hour – Part III – Trauma

“The Golden Hour” is a window of opportunity that impacts a patient’s survival and quality of life following a number of illnesses and traumatic injuries. This article will briefly discuss the importance of seeking stabilizing treatment after a traumatic injury.

The role of Emergency Medical Services (EMS) is threefold:

  • Get to the patient quickly and safely
  • Fix what we can fix; and
  • Quickly get the patient to the right hospital.

Anything EMS can do to compress the time of any of these time periods is good for the patient. Military field hospitals were introduced many years ago and have saved countless lives over the years. Our local hospital functions much like a military field hospital, in that, we are very successful at treating what we can, and stabilizing and transporting what we cannot.

Life-threatening traumatic emergencies are often placed on a helicopter on-scene (providing one is available) and flown to a trauma center, however, the number patients who present to the hospital in the back of a pickup truck or an SUV may surprise you. I took care of a thirteen y/o patient who was in four feet of water on the shore line when his brother decided to spray him with water from the Jet Ski he was riding. The result was a traumatic flail chest and collapsed lung who required chest tube placement. We were able to stabilize his injuries & respiratory status and transfer him to a trauma center for further treatment. This is only one of many stories I could tell of life-saving treatment rendered within the golden hour, at this facility.

When we talk about broken bones, our local hospital is adept at immobilization of the joint above and below the break, and providing pain medication until orthopedic assistance can be followed up. This is the same as most other larger hospitals. Orthopedic physicians are not on-call except for very obvious life-threatening emergencies caused by multiple compound fractures that may require surgical intervention and mechanical fixation only performed in the operating room.

I would like to challenge each reader of this article to begin a “CALL TO ACTION” in your own homes. What do you do if a loved one experiences dizziness or sudden chest pressure and pain? Do you panic? Mock codes for different scenarios are performed in the hospital for repetitive teaching opportunities. You never know when that situation may happen in your own home. My message to you with this last article is to ensure that you are aware of one of the most important considerations in your homes. Are you ready to act within? “THE GOLDEN HOUR”