Erickson Tribune

Monarch Landing

UPDATED: Thursday, May 10, 2007

The ‘golden hour’

Posted on Thursday, May 10, 2007
 

Immediate diagnosis and treatment can save your life

By Meghan Streit
THE ERICKSON TRIBUNE

When you have a medical emergency, seeking treatment within an hour after the injury or onset of symptoms can mean the difference between a health incident and a medical crisis.

The first 60 minutes, called the “golden hour” by emergency room staff, is the window of time in which doctors can typically administer treatments that can reduce the long-term impact on your health—possibly even save your life.

“The golden hour concept comes from the trauma literature,” says Ohio-based emergency room physician Scott Wilber, M.D. “The concept is that when you have someone who is seriously injured, giving them care in the first hour is most likely to result in a good outcome.”

Wilber is a member of the Society for Academic Emergency Medicine’s geriatric task force. He says the emergency medical treatment is even more critical for older adults because the ramifications of heart attacks, strokes, and fall injuries— like trauma cases—can also be dramatically reduced during the “golden hour.”

“When someone comes in with a trauma, we activate the trauma team as soon as we get the call from the ambulance that they are coming in. We have a surgeon, x-ray technician, and other specialists ready, so that we can do everything possible in that first hour to save that person’s life,” says Dr. Rahul Khare, assistant professor of emergency medicine at Northwestern Memorial Hospital.

“The reason that phrase keeps on going is that we’ve realized that heart attacks aren’t much different,” he says.

More treatment possibilities
Advancements in medical technology give doctors more treatment options and improve patients’ chances of recovery. “Now we have treatments, but they are very time-sensitive,” Wilber says.


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If a patient seeks immediate treatment for a stroke within three hours, Wilber says doctors can use an IV treatment to break up the blood clot. Within six hours, he says, doctors can try inserting a catheter to remove the clot.

“To be able to get the three-hour treatment, you really need to present to the emergency room right at the onset of symptoms,” Wilber says.

Don’t ignore the signs
People often mistake symptoms of a heart attack or stroke as a less serious problem like acid reflux, and try to endure the pain until it passes—missing that critical period of time when treatments are most likely to work.

“Unfortunately, there’s a lot of evidence that people wait a couple of hours, or a even couple of days, before coming to the emergency room or calling 911,” Khare says.

Khare says even the time spent waiting at the emergency room can cut into the “golden hour” needed to save a patient’s life after a heart attack, stroke, or fall injury. He says calling an ambulance could be a better option because trained paramedics can make an initial diagnosis and begin treatment immediately.

Older adults who live alone are particularly vulnerable to delaying emergency medical care because they may not realize or want to admit they’ve sustained a heart attack or a stroke, Wilber says. “So they stay home and stay home, and finally when they can’t get it to go away, they come in.”

Wilber says people who live with a spouse, family, or at a retirement community often seek treatment sooner because other someone around them notices they are experiencing unusual symptoms. “They’re going to call an ambulance for you,” Wilber says.

Medical care when you need it
No one wants to think about dealing with a medical emergency, but knowing that people who know you and care about your health are always available can relieve a lot of anxiety.

“I feel safer knowing that in the event of something happening in the middle of the night, there’s medical help close by,” says Ginny Markey, who lives at Monarch Landing in Naperville, where an on-site emergency medical team is always available.

Monarch Landing’s security team includes eight certified emergency medical technicians and an on-call paramedic. Residents’ homes all include emergency pull cords that transmit a signal directly to the front desk to dispatch the medical team. The e-call system means people can get help much faster than the five-to-seven minutes it could take an ambulance to arrive.

“We try to reach the community member’s home in under two minutes,” says Security Manager Patrick Hayes. “If we’re in the immediate area, we can get there in under a minute.”

Team of experts working together
Medical care doesn’t end with emergency treatment. Dr. Thomas Morris, Monarch Landing’s on-site physician, works closely with the emergency team to deliver the highest quality care to residents in every situation.

“They can enter the apartment and then get me on a phone,” Morris says of the first-responders, who are alerted when someone pulls the emergency cord in his or her home.

And unlike the medical team that would treat you if you had an emergency at your own house, Morris and the Monarch Landing emergency team know their community members’ medical histories—which means they can quickly make critical medical decisions.

“If something happens to me in my apartment home, there will be somebody there to check on me, get me to the doctor, or take care of me,” says Barbara Smart, who lives at Monarch Landing.



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