Golden Hour of EMERGENCY

Accidents and injuries are among the leading causes of death and disability in the world regardless of age, sex, income, or geographic region. The 'golden hour' is the critical period of 1 hour after an injury, accident, or trauma.

The goal of Emergency Care for trauma patients is to ascertain and treat life-threatening injuries, and stabilize the patient with emergency interventions such as fracture immobilization, blood transfusion, assisted breathing, wound closure, ICD placement, vasopressors, etc. It is promptly followed by detailed evaluation, investigation, radio-imaging, planning for urgent surgery, or medical management.

Accident victims should be taken to a well-equipped and properly manned Emergency Medicine department preferably within the 'golden hour'. During transport, care should be taken to minimize movement of the spine and injured limbs. It has been observed that prompt and definitive care within the 'golden hour' gives the patient the best chance of survival.

The death toll of accident victims in India is staggering >1.4 lakhs per year. Nearly half of them can be potentially saved if bystanders come forward to help and move the victim to a hospital. Unfortunately, most accident and trauma victims do not reach the hospital in time due to the lack of proper emergency facilities and ambulances in India as well as indifference from the bystanders. Our citizens are hesitant to help an accident victim to reach a hospital either for fear of facing financial liabilities or getting intertwined with the police and legal hassles that are associated with accidents.

The Supreme Court of India came up with a landmark guideline in 2016 mentioning that no 'Good Samaritan' who comes forward voluntarily to help a victim can be burdened with financial liabilities by the treating hospital nor can be inducted forcefully into policy and legal issues. The bystander who brings an accident victim to the hospital can leave the hospital immediately without disclosing his identity.

With the increasing awareness of the 'Good Samaritan Law', we can hope that we will be able to treat trauma victims within the 'golden hour' and save precious lives.

DR. SANJUKTA DUTTA
Head- Emergency Medicine, Fortis Hospital, Kolkata