On the fifth day of Christmas Happy Medic Gave to me…
5 Golden Hours
The golden hour. Every time I hear that term now, especially from my own lips on the pilot episode of Beyond the Lights & Sirens, I hear the little aliens from Toy Story and their signature line “Ooooooooooohhhhhh.”
This neat time table mainly exists to remind us not to mess around on scene too long with traumatic injuries. In fact, if the golden hour were accurate, most of our military would be dead instead of injured.
The key is getting your patient to definitive care, not just hitting the ER loading dock at 59 minutes and high fiving each other. So how does the Army keep trauma victims alive for more than an hour? By bringing proven elements of that definitive care to them quickly. Things such as tourniquets, IOs and blood substitute, not to mention a remarkably liberal definition of mechanism to suggest C-Spine injury.
With so many injuries and so few back boards, these units focus on life threats present instead of “protecting” what might or might not have happened. This combined with an advanced understanding of clotting, homeostasis and the resiliency of the human body to temporary shunting equals more soldiers surviving traumatic injury outside of the precious golden hour.
If you’re sitting around on scene of a major trauma victim trying for your third tube or another 20g IV, perhaps the golden hour is for you. But, I have bad news, the Profession of EMS will be moving on without you. We were born from the military, take most of our cues from it, yet are dragging our feet in modern times…what gives?