The Golden Hour
A tool for calculating sufficient time for casulties to reach emergency medical services
The critical hour between life and death
Road safety is a major cause of death worldwide, and South Africa has one of the highest road fatality rates .While numerous engineering and medical measures are investigated to improve safety, the accessibility of emergency care facilities is often overlooked.
The golden hour is the first hour after a road accident with casualties, during which time if a seriously injured person is attended to by the emergency services and taken to a medical centre, their chances of survival increase dramatically.
“There is a “golden hour” between life and death. If you are critically injured you have less than 60 minutes to survive. You might not die right then; it may be 3 days or 2 weeks later – but something has happened in your body that is irreparable." (Dr Adam Cowley, 1960)
A study by Vanderschuren and McKune (2015), highlighted the critical role that access to emergency care in rural areas plays, especially since 50% of the world’s population resides in these regions. Rural fatalities are frequently omitted from international research. In Africa, with its vast open spaces, addressing these challenges is particularly crucial.
CASE STUDY
(1) Emergency care facility access in rural areas in the Western Cape within the Golden hour (Vanderschuren and McKune, 2015)
(2) Critical rural zone identification in rural areas in the Western Cape (Vanderschuren and McKune, 2015)
Western Cape, South Africa
The Western Cape, a rural province in South Africa with low population volumes and high-volume roads, was analysed as an example for access to trauma care in rural areas.
At the time of the study, the Western Cape's rural areas were served by 44 Emergency Medical Services (EMS) stations and 29 medical facilities equipped to provide definitive trauma care.
53% of fatalities in rural areas
occur outside of the 'Golden Hour' i.e when chances of survival or full recovery are high.
The Safe Systems Approach
Swift post-crash care is crucial for saving lives. In high-risk crash zones within the Western Cape, the fatality risk is up to nine times higher than the rural average in the province. Expanding the number of EMS stations in these areas can significantly reduce fatalities and lessen the severity of injuries.
