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The 60 minutes after a traumatic injury is sometimes referred to as the “golden hour,” a window of time in which a victim is thought to have the greatest chance of survival if given medical attention. Though this idea has become conventional wisdom, rushing to arrive within the window carries risk — speeding EMS vehicles aren’t immune from accidents, after all — and the exact relationship between response times and the survival odds has not been definitively established.
A 2009 study published in the Annals of Emergency Medicine, “Emergency Medical Services Intervals and Survival in Trauma: Assessment of the ‘Golden Hour’ in a North American Prospective Cohort,” analyzed a patient registry of 3,656 adult trauma victims transported by 146 EMS agencies to 51 hospitals between 2005 and 2007. Patients were chosen based on a uniform set of health criteria: blood pressure reading, respiratory rate and Glasgow Coma Scale score. Of the 3,656 subjects studied, 806 died as a result of the incident that prompted the emergency response.
Major points made in the study include:
The authors note that previous studies have reached opposite conclusions, and much EMS policy continues to focus on response speed. However, this study’s findings do not support the idea that promptness prevents deaths. The authors hypothesize that the “golden hour” idea may well be dependent on timely treatment at the hospital itself, adding that “such a possibility would lend credence to a ‘golden hour’ concept and be consistent with the previously demonstrated hospital-based effect on survival.”
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