4/30/2023 0 Comments The golden hour timeWithin the polar circles and just outside them, the Sun does not sink lower than 6 degrees below the horizon during the summer, so the golden hour can last all night. However, the subgroup of shock patients requiring early critical resources and arriving after 60 minutes had higher mortality.Ĭopyright © 2015 American College of Emergency Physicians. In Oslo (about 60° north) and the northernmost tip of Antarctica (about 60° south), the golden hour lasts over 90 minutes at that time of the year. However, shock patients requiring early critical hospital resources and arriving after 60 minutes had higher 28-day mortality (aOR 2.37 95% CI 1.05 to 5.37) this finding was not observed among a similar traumatic brain injury subgroup.Īmong out-of-hospital trauma patients meeting physiologic criteria for shock and traumatic brain injury, there was no association between time and outcome. Out-of-hospital time greater than 60 minutes was not associated with worse outcomes after accounting for important confounders in the shock cohort (adjusted odds ratio 1.42 95% confidence interval 0.77 to 2.62) or traumatic brain injury cohort (aOR 0.77 95% CI 0.51 to 1.15). There were 778 patients in the shock cohort (26% 28-day mortality) and 1,239 patients in the traumatic brain injury cohort (53% 6-month Glasgow Outcome Scale-Extended score ≤4). Primary outcomes were 28-day mortality (shock cohort) and 6-month Glasgow Outcome Scale-Extended score less than or equal to 4 (traumatic brain injury cohort). In Oslo (about 60 north) and the northernmost tip of Antarctica (about 60 south), the golden hour lasts over 90 minutes at that time of the year. Inclusion criteria were systolic blood pressure less than or equal to 70 mm Hg or systolic blood pressure 71 to 90 mm Hg with pulse rate greater than or equal to 108 beats/min (shock cohort) and Glasgow Coma Scale score less than or equal to 8 (traumatic brain injury cohort) patients meeting both criteria were placed in the shock cohort. This was a secondary analysis of patients with shock and traumatic brain injury who were aged 15 years or older and enrolled in a Resuscitation Outcomes Consortium out-of-hospital clinical trial by 81 emergency medical services agencies transporting to 46 Level I and II trauma centers in 11 sites (May 2006 through May 2009). A target ‘door to needle’ time of one hour for first dose empirical intravenous antibiotics continues to be promoted nationally. We evaluate patients with shock and traumatic brain injury who were previously enrolled in an out-of-hospital clinical trial to test the association between out-of-hospital time and outcome. Neutropenic sepsis remains a time critical and potentially fatal complication of systemic anti-cancer therapy.
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