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What is the Golden Hour?

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If you’re someone who regularly reads about the latest air ambulance and air medical news, one idea you’ve no doubt come across more than a few times is the storied “golden hour.” This term appears on the web sites of many operators in countries around the world, where the idea is presented to the public in a variety of ways. An online search for golden hour produces gripping, true tales of trained air medical professionals saving lives when time is of the essence.

Yet, judging by the comments we sometimes see on articles related to this subject, some confusion – even contention – remains about the concept. So, what exactly is meant, in air medical terms, when we refer to the existence of a golden hour?

The Definition

In short, the golden hour refers to a very critical, but brief, window of time – literally, sixty minutes following an injury – in which there is thought to be a much higher chance that critically injured patients and stroke/cardiac arrest victims can be saved if they are able to reach medical treatment from the appropriate healthcare professionals.

Sixty minutes may not seem like much time, and that’s because it isn’t. Still, in an emergency situation, a single “golden” hour provisions enough time for emergency services to be called, for an air ambulance to be dispatched to the patient’s location, and for that air ambulance to bring the critical-care patient to an appropriate treatment location. Given the call, emergency dispatchers, first-responders, air ambulance crews, and receiving hospital staff can communicate and coordinate a huge amount of critical data and vital actions in a matter of minutes.

The Grey Area of the Golden Hour

Despite its seemingly self-evident nature, the specifics of the golden hour are occasionally the subject of debate. The golden hour is often referred to as being backed up by statistical evidence and/or the personal opinions and experience of some healthcare workers (we are not here to dispute or confirm that – such a discussion would be far beyond the scope of this week’s blog). Because of the vagueness with which the golden hour is described, the idea has some softness to its appearance that is begging for some to be skeptical of its efficacy — some even speculating that it’s a marketing ploy or part of a conspiracy.

Could anyone truthfully deny that there is a much higher chance of saving a patient’s life if they reach treatment within an hour after experiencing a trauma? Unlikely; the point of contention seems to be the idea exact amount of time it takes for the chances of recovery to fall off dramatically.

The problem, such as it is, could be that everyone in the healthcare and air medical sector’s individual definitions of “golden hour” may appear to differ slightly. Where some healthcare entities loudly proclaim the “golden hour” to be a literal sixty-minute period, others extend the definition to mean several hours.

Regardless of whether or not the chances for a patient’s successful recovery immediately drop off exactly one hour following a trauma, it would be quite hard to find someone who would argue with the idea that “the faster a trauma patient gets to the best possible healthcare, the better their chances of recovery are.” (Disagree? Let us know your thoughts in the comments below this blog)

An Ever-Changing Window

One of the finer approaches to the concept of the golden hour, rather than rigidly defining it as a fixed, finite period of time, may be to allow the individual air medical mission circumstances to dictate the “golden hour” window. In actuality, this isn’t just an idea – it’s what healthcare professionals already do.

For example, stroke victims are often said to have a three-hour window in which to reach treatment for the best chance at reversal and recovery. Of course, there is absolutely nothing to be gained by delaying treatment for a stroke if the patient is able to reach the best possible treatment sooner.Many of us would probably agree that the term “golden hour,” while not really a misnomer, is not meant to be taken 100% literally. In air medical vernacular, golden hour simply refers to the idea of ensuring that all patients in need are able to reach appropriate care in as little time as possible. Because of the spread of air ambulance services, it is now a possibility for many Americans who would otherwise be located too far from an appropriate treatment center to reach the care they need in case of a medical emergency – often well within the bounds of an hour by rotor or fixed-wing air ambulance.

But the decision to transport a critical-care patient by air ambulance isn’t just about getting them to the hospital in as little time as possible. Indeed, air ambulance services are known for their ability to provide a particularly high level of care while the patient is on-board, often with advanced medical equipment that is not in wide usage on ground ambulances. The best air ambulance services may have highly-trained specialists on-board the aircraft who can attend to a critical-care patient’s needs before the patient even arrives at the destination hospital. In the golden hour, this factor alone can be a potential lifesaver.

The critical ‘Golden Hour’ period for some stroke victims is often thought to be 3 hours from the time of the stroke.

Even in non-emergency cases, the golden hour rule can still apply to a certain degree. Every day, people use private air ambulances to quickly fly their loved ones long distances to reach the best possible treatment. Where, once, transporting a patient across states, across the country, or even across international lines took a huge amount of time and effort – certainly a far too long and dangerous trip for critical-care patients – air ambulances have made it possible for patients to reach the best healthcare in a matter of minutes or hours, no matter where they are in the world.

The Golden (Hour) Rule

The most important thing, in a medical emergency of any kind, is not to waste any time getting the patient into the care of trained medical professionals. If the patient can reach appropriate care in an hour, there’s no reason to have him or her wait longer. Likewise, if a trauma patient is located in a rural area and the nearest appropriate treatment center is sixty-three minutes away, it would be rather inappropriate to give up all hope.

So, when international air ambulance services speak of the importance of the golden hour, they are not referring to a grandiose or mystical period of time that just happens to be exactly the length of an hour, but to an ever-changing (but well-defined) window of time in which a critical-care patient needs to reach appropriate healthcare for his or her best chance at recovery, reversal, and preservation of quality of life.

We at Air Ambulance Weekly would like to know: As someone involved or associated with the air medical field, what does the golden hour mean to you? Please share your comments, opinions, and/or experiences below.

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Discussion
  1. Alberta Muetzel

    12 / 30 / 2011 8:10 am

    This blog is definitely rather handy. although I am only starting out therefore it’s really fairly small, nothing like this site. Can link to a few of the posts here as they are quite. Thanks much.

    Reply

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