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In Medicine, what is the Golden Hour?

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  • Written By: Mary McMahon
  • Edited By: Kristen Osborne
  • Last Modified Date: 02 November 2016
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The golden hour is a window of opportunity in which rapid medical intervention can save a patient's life or make a significant difference in the level of impairment a patient experiences after recovering from a medical emergency. People often use this term in the context of trauma medicine, where many members of the lay public are aware that rapid transport to a trauma center can make the difference between life and death, but it is also important for treatment of strokes, heart attacks, and other medical issues.

The “hour” in this case is actually more flexible than the slang term would have many people believe. For some medical issues, patients need critical medical attention in minutes, not an hour, or they will die. A classic example is a patient with an injury like a ruptured aortic aneurysm, where blood loss would kill the patient in far less than an hour. Other patients may recover well if they receive treatment between two and three hours after the incident, rather than in the first hour.

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As a general rule of thumb, the golden hour can be a useful tool for medical professionals. Stressing the need for prompt medical treatment to patients ensures that people enter the hospital as soon as possible after they start exhibiting symptoms like slurred speech or chest pain, providing more opportunities for treatment. For people like paramedics and ambulance crews, keeping the golden hour in mind is important for making decisions about how much treatment to provide at the scene before loading a patient up for transport to a hospital.

During the golden hour, the goal is to assess the patient, determine what is wrong, and start providing interventions to stabilize him. These can include surgery, medications, and other medical treatments. Prompt treatment can head off shock, reduce the risk of infection, and preserve the internal organs so the patient will be less likely to experience complications after the emergency is over.

Some of the most radical results with early treatment within the golden hour can be seen in the case of stroke. If a patient with a stroke arrives at a hospital and gets treatment within an hour, doctors can radically reduce the chances of cognitive deficits. The patient will find stroke recovery much easier, and will be less likely to need assistance after recovery because she will retain many key cognitive functions. When patients encounter delays in treatment, their brains tend to experience more damage, and they can develop severe impairments.

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Rotergirl
Post 1

The "golden hour" concept is actually fairly new, as far as medicine is concerned. I first remember hearing the term in the late 70s or early 80s. But, it made sense in light of advances being made in trauma care. I mean, the paramedic program was just instituted in the early 70s, so on-the-scene trauma care was still novel. But it underlined what doctors had always said: the sooner a patient gets treatment, the better the prognosis. Head off the problems before they become problems and you're ahead of the game.

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