JEMS.com Editor’s Note: Will Chapleau’s Aug. 21, 2008 article “Prehospital Time” discusses whether the golden hour applies to all critically injured patients. Read more about the golden hour vs. the golden period. Click here to read “Prehospital Time.”
There is a golden hour between life and death. If you are critically injured, you have less than 60 minutes to survive.” That’s R. Adams Cowley, the pioneering physician and architect of trauma medicine who founded the nation’s first shock trauma center in Baltimore, explaining the defining element of trauma care. It’s because of Dr. Cowley’s ground-breaking work that the Maryland State Police flew their first medevac transport in 1969. In the years since, medical advances have extended the golden hour in some instances, but the helicopter unit’s work has continued to be founded on the concept. Still, a recent legislative audit has shown, the state police’s clock is slightly off. The time element is critical not only to saving lives but also to developing and managing the emergency medical response fleet. Without reliable data, it’s tough to assess if Maryland has too few or too many choppers in use today.