Erickson Tribune

Sedgebrook

UPDATED: Thursday, May 10, 2007

The ‘golden hour’

Posted on Tuesday, May 01, 2007
 

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   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.

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.

Medical care when you need it
Warren Breckenridge
lives at Sedgebrook, where an on-site emergency medical team is always available. “The most important part to me is the fact that the staff is trained in emergency medicine,” Breckenridge says.

If a problem does arise, the coordinated efforts of Sedgebrook’s security and medical staff and the use of the newest technology ensure residents get the treatment they need right away.

“I love that Erickson HealthSM has specialists in geriatric medicine,” says  Sedgebrook resident Gene Golemo. “With the electronic medical records system, my history goes into the computer, so if I ever go to the hospital, my records will be there.”

‘Safe and secure’
“Residents feel safe and secure with our medical team and officers,” says Gary Kupsak, Sedgebrook’s facilities manager, who oversees a 12-person team. “Every time they treat a resident, he or she ill tell other residents how  comfortable the team made them feel and how professional they were.”

Sedgebrook’s emergency medical team includes two paramedics and six  emergency medical technicians, and the rest of the security team is all trained first-responders. Kupsak says the team has a “full array of medical equipment”and “can do almost everything an ambulance can do.”

A team of experts working together
Medical care doesn’t end with emergency treatment. Dr. Elliott Kroger, Sedgebrook’s on-site physician, works closely with the emergency team to deliver the highest quality care in every situation.

“They can expedite a transfer to the hospital when that’s necessary,” Kroger  says. “They can do it in a manner that’s appropriate…, and they can notify the [patient’s] doctor, so that a trip to the emergency room can be a little more informed.”



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