By Elizabeth Sitotombe

SANDRA (not her real name) was involved in a near-fatal accident somewhere near Norton, along the Bulawayo road. Luckily for her, she was able to get help in time. At the hospital, she underwent a successful life-saving operation. According to her, her physician commended the speed with which she was brought to hospital and how this had contributed in saving her life. In medicine, they call this the ‘golden hour’. This essentially means ‘as soon as possible’ or in the nick of time. It is a term that suggests that an injured or sick person must receive definitive treatment within the 60 minutes from the time of injury or appearance of symptoms. It is believed that once this time has lapsed, the risk of death or long-term complications will increase significantly.

The notion of the ‘golden hour’ is derived from the French military’s First World War data. It was promoted by the military surgeon and head of the University of Maryland Shock Trauma Center, R. Adams Cowley, who is quoted as saying: “There is a golden hour between life and death”. Then, the doctors believed that, if an injury had caused potentially irreparable damage to the body, it needed to be taken care of within the one hour time frame, or the person would die in the next few days or weeks. The golden hour in road traffic accidents. In Zimbabwe, road traffic accidents are proving to be more of a menace than many diseases combined.

According to the Traffic Safety Council of Zimbabwe, an average of five people die on Zimbabwean roads every day while, on average, 38 people are injured in accidents daily. In 2023 alone, 51 924 accidents were reported on the country’s roads, resulting in 2 099 deaths and 9 955 injuries. And according to the World of Statistics released in 2023, 41 per 100 000 people die from road traffic injuries in Zimbabwe, with the nation losing over US$400 million in costs.

In 2023 alone, 51 924 accidents were reported on the country’s roads, resulting in 2 099 deaths and 9 955 injuries.

According to a book Emergency Medicine and Trauma by Ozgur Karcioglu from Ghana, in low and middle income countries, like Zimbabwe, about 80 percent of road traffic injury deaths occur in the pre-hospital setting. Many of these injuries and deaths could be prevented with the timely arrival of emergency pre-hospital medical services at accident scenes.

Karcioglu says: “Timely emergency pre-hospital care to traffic accident victims at the accident scene and subsequent transportation to the health facility may reduce the probability of injury severity and death, trauma experts consider the first 60 minutes after the injury occurred as the most important period to save lives.”

Unfortunately, in Zimbabwe, that is not the case. Not many Zimbabweans are well versed in giving first aid which is crucial; some will choose to transport the injured to hospital without stabilizing them at the scene, while others will simply stand by, taking pictures and exclaiming at how the injured look. Intervention in the first few minutes following a road accident may determine if a person lives or dies. Currently, Zimbabwean doctors and nurses are undergoing training in Advanced Trauma Life Support Courses (ATLS) and Advanced Trauma Course (ATC) for nurses.

According to course director Dr Howard Wain from South Africa, the ATLS is designed and facilitated by the American College of Surgeons and seeks to help doctors as well as nurses to manage severely injured trauma patients in that first hour or two after arriving at the hospital.

Speaking to Sunday News, Dr Wain said: “What we know is that if you get that first hour or two wrong, things go poorly and if you get it right you have a far higher chance of that patient surviving. History has proved that instituting these trauma courses helps with better outcomes from trauma and it has been seen in many countries in the world.”

The golden hour in heart attack patients

The first 60 minutes of a person having a heart attack are crucial. Appropriate action within the first 60 minutes of a heart attack can reverse its effects. This is because if the heart muscles have no blood supply in the first 80-90 minutes, the heart muscles start dying.

Strokes

Lately, the number of stroke patients has been on a rise, especially in young adults. A stroke happens when the blood flow to an area of the brain is cut off, causing the brain cells to die from lack of oxygen. Stroke patients have a much higher chance of avoiding longterm brain damage if the receive timely treatment. According to the American Heart Association, for every minute a stroke patient is left untreated, the average patient loses 1,9 million brain cells. With each passing hour without treatment, the brain loses as many brain cells as it does in almost 3,6 years of normal aging. When you see someone collapse in town or by the roadside, remember time is of the essence. You can save a life by taking a course of action. Do not simply pass by and hope the next person will feel compelled to attend to the injured.