When it comes to a traumatic injury, especially if an emergency surgery needs to be performed to save a life the first few minutes or hours can be very crucial and important to determine the patient's wellbeing and the clinical outcome of any emergency procedure conducted. This period is called the Golden Hour which in emergency care means a difference between survival and death.
The concept of Golden Hour refers to the window of opportunity right after the injury when an intervention is made at the earliest that could impact the survival of the patient. It has been observed that the sooner a trauma victim reaches the emergency care unit, the better the chance of their survival. In fact, several studies have shown how the actions taken during the golden hour have a considerable impact on trauma mortality.
Significance of the Golden Hour
In emergency situations, the victim may have an obstructed airway or critically injured lungs severely affecting breathing or bleed out unless there is an emergent action taken by an emergency physician or trauma surgeon within the Golden Hour.
One of the objectives of this article is also to educate the general public to identify key signs and symptoms that would need interventions within the golden hour and hence aid the health care system to take care of the victim better.
Visit the emergency hospital in Bangalore near you, if there are any trauma situations. Trauma care is very important for victims and requires the best emergency medical services in Bangalore.
Management of trauma during the golden hour
First Response and Golden Hour:
The first response is an essential part of the golden hour in an emergency case. You may be in a situation when you have to take on the job of being the first responder. This can be achieved by following a simple method and ensure that the patient is attended quickly, safely and effectively.
- At the scene of the trauma, prepare yourself to rush to help, take a moment to look around and survey the scene.
- Scene survey – Check if it is safe to respond to the victim, there is no fire, leaking fuel, fast-moving traffic around the accident site, fallen electricity lines etc.
- Call for help as soon as possible and give an accurate location of the accident. While describing the scene make sure to include information about the number of victims, the presence of hazards to the responders. Don’t forget to share your phone number so that the rescue team can call you back for updates. Once help has arrived, the actions for stabilising the patient and reaching the patient to the right hospital quickly will become easier. Also, Look out for expert assistance and do not try to get a victim out on your own who is trapped in the vehicle.
- Approaching the victim: once you know the place is safe and help is on the way, try to speak to the victim, if you get a coherent response, this would mean that the patient is conscious and has an intact airway. If not then perform an initial assessment using the ABC method
Airway: PRESENCE OF BLOOD vomitus, loose teeth etc. in the mouth
Breathing: there is no visible chest rise
Circulation: the patient is pale, or there is visible bleeding from the victim’s body
- Should the victim need resuscitation you may attempt to do CPR if you have been trained to do so.
- If the patient is breathing and does not need CPR, open the clothing to look for any bleeding wound. Should you find one, use some sort of direct pressure with a thick pad or clothing on the wound to stop the bleeding, while attempting to stop bleeding would suggest one-use gloves, eye protection & a face mask for personal protection
- Do not give anything to the patient to eat or drink. This is because when somebody is unconscious or semiconscious, giving the victim water or food may cause them to choke and further complicate the situation.
- Watch out for Shock: Shock is something that would cause severe bleeding which would lead to a severe drop in blood pressure and lack of blood perfusion to the end organs. In case the patient appears to be pale, or breathes very fast or shows a faint pulse, suspect shock and make sure the patient is immediately rushed to the hospital.
- In case you have to move the patient elsewhere from the accident spot, say in case there is a fire or risk of explosion, make sure to move the victim “like a log” that avoids bending the spine of the victim. Use a plank or solid support to carry the patient on it. If the spine is bent and you disrupt a fracture, it might lead to damage to the spinal cord and the victim might end up being completely paralysed.
- Reassure the victim to keep calm as panic will increase the heart rate which could further increase the bleeding. Thus, it is essential for the victim to keep calm until the help arrives.
- Most often bystanders inform the ambulance and leave the accident spot. However, it is ideal to stay by the side of the victim, call for help and constantly keep giving updates to the paramedical staff or nurses and they will be better prepared to rescue the victim.
While these tips will hopefully help guide your response should you have to attend to a victim of trauma, in making the optimal usage of the Golden Hour, ensuring the victim reaches the hospital safely and swiftly for better clinical intervention, You can make a difference.
If I stop to help this man, what will happen to me? For this, the good Samaritan said, “if I do not stop to help this man what will happen to him? - Martin Luther King Jr.
If you have reached the end of this article, like the good Samaritan, you are one of a kind who wishes to help someone in need. It is hoped that these few pointers could help guide your response and keep you safe while you help the victim of trauma.
