The Golden Hour: Scientific Fact or Medical “Urban Legend”?

Lerner, E. Brooke; Moscati, Ronald

doi:10.1111/j.1553-2712.2001.tb00201.x

Cited by 402 publications

(245 citation statements)

References 17 publications

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“…A primary benefit of HEMS has been thought to be shorter time periods to treatment. 10 Although the concept of the "golden hour" may not be supported by the evidence, 26 longer time intervals between severe injury and definitive care have been associated with a significant increase in mortality. 27 It has been estimated that 84% of all U.S. residents have access to a level I or II trauma center within one hour and about onethird of these residents have this access only if flown by helicopter.…”

Section: Discussionmentioning

confidence: 99%

Reduced Mortality in Injured Adults Transported by Helicopter Emergency Medical Services

Sullivent

Faul

Wald

2011

Prehospital Emergency Care

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Background. Some studies have shown improved outcomes with helicopter emergency medical services (HEMS) transport, while others have not. Safety concerns and cost have prompted reevaluation of the widespread use of HEMS. Objective. To determine whether the mode of transport of trauma patients affects mortality. Methods. Data for 56,744 injured adults aged ≥18 years transported to 62 U.S. trauma centers by helicopter or ground ambulance were obtained from the National Sample Program of the 2007 National Trauma Data Bank. In-hospital mortality was calculated for different demographic and injury severity groups. Adjusted odds ratios (AOR) were produced by utilizing a logistic regression model measuring the association of mortality and type of transport, controlling for age, gender, and injury severity (Injury Severity Score [ISS] and Revised Trauma Score [RTS]). Results. The odds of death were 39% lower in those transported by HEMS compared with those transported by ground ambulance (AOR = 0.61, 95% confidence interval [CI] = 0.54-0.69). Among those aged ≥55 years, the odds of death were not significantly different (AOR = 0.92, 95% CI = 0.74-1.13). Among all transports, male patients had a higher odds of death (AOR = 1.23, 95% CI = 1.10-1.38) than female patients. The odds of death increased with each year

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Section: Discussionmentioning

confidence: 99%

Reduced Mortality in Injured Adults Transported by Helicopter Emergency Medical Services

Sullivent

Faul

Wald

2011

Prehospital Emergency Care

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“…On the basis of data from the Vietnam war, the generally accepted policy is that severely injured trauma patients must undergo definitive treatment in hospital within 1 h of the injury (the golden hour) to optimize the chances of survival [2]. Although some information is available about the period prior to hospital treatment, not enough is known about the predictors of death when patients actually arrive in hospital alive.…”

Section: Introductionmentioning

confidence: 99%

Predictors of Death in Trauma Patients who are Alive on Arrival at Hospital

Lichtveld¹,

Panhuizen

Smit³

et al. 2007

Eur J Trauma Emerg Surg

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Objective: To determine which factors predict death occurring in trauma patients who are alive on arrival at hospital Design Prospective cohort study Method Data were collected from 507 trauma patients with multiple injuries, with a Hospital Trauma Index-Injury Severity Score of 16 or more, who were initially delivered by the Emergency Medical Services to the Emergency Department of the University Medical Centre Utrecht (UMCU) during the period 1999-2000. Results: Univariate analysis showed that every year of age increase resulted in a 2% greater risk of death. If the patient had been intubated at the scene of the accident, this risk was increased 4.3-fold. Every point of increase in the Triage Revised Trauma Score (T-RTS) reduced the risk of death by 30%. A similar (but inverse) tendency was found for the HTI-ISS score, with every point of increase resulting in a 5% greater risk of death. There was a clear relationship between the base excess (BE) and hemoglobin (Hb) levels and the risk of death, the latter being increased by 8% for each mmol/l drop in BE, and reduced by 22% for each mmol/l increase in Hb. The risk of death occurring was 2.6 times higher in cases with isolated neurotrauma. These associations hardly changed in the multivariate analysis; only the relation with having been intubated at the scene disappeared. Conclusion: The risk of severely injured accident patients dying after arriving in hospital is mainly determined by the T-RTS, age, presence of isolated neurological damage, BE and Hb level. Skull/brain damage and hemorrhage appear to be the most important causes of death in the first 24 h after the accident. The time interval between the accident and arrival at the hospital does not appear to affect the risk of death.

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“…Effective and seamless teamwork and unambiguous communication are necessary to manage the situations. [2][3][4] The quality of team work also affects the patient's experience of the care quality. [5] Team members may possess different skills, qualifications and work histories, [6,7] so it would be beneficial, if representatives of various professional groups practiced the management of acute situations together, in multiprofessional teams.…”

Section: Introductionmentioning

confidence: 99%

Nursing students’ experiences of multiprofessional simulation education

Salminen‐Tuomaala

Jaskari

2017

CNS

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Objective: To describe how nurse students specializing in acute nursing care and practical nurse students specializing in emergency care experienced a joint simulation education program and the usefulness of simulation education in general. Methods: Data were collected using a questionnaire from nurse and practical nurse students (N = 21), who had together undertaken a multiprofessional simulation-based course. Quantitative data was analyzed using statistical methods, whereas inductive content analysis was conducted to analyze qualitative data. Results: Respondents found simulation education useful for the development of theoretical and practical skills and interaction skills. Shared competence was appreciated. It consisted of sharing one's knowledge, learning from others, learning together and learning teamwork skills. Respondents regarded multiprofessional simulation education as an effective method in learning how to deal with acute, recurrent or infrequent situations. Simulated learning also provided respondents with explicit experience of multiprofessional collaboration in emergency care and facilitated their learning of collegiality with help of constructive feedback. Conclusions: Simulation education can promote nursing students' technical and non-technical skills and help students form a clearer perception of multiprofessional collaboration. Careful planning and timing of joint simulated learning sessions is recommended.

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The Golden Hour: Scientific Fact or Medical “Urban Legend”?

Cited by 402 publications

References 17 publications

Reduced Mortality in Injured Adults Transported by Helicopter Emergency Medical Services

Reduced Mortality in Injured Adults Transported by Helicopter Emergency Medical Services

Predictors of Death in Trauma Patients who are Alive on Arrival at Hospital

Nursing students’ experiences of multiprofessional simulation education

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