Golden Hour: How Quick Action After Road Accidents Saves Lives - Dr Binoy Xavier

It’s a call we hear all too often in the Emergency Medicine & Trauma Care Department: an ambulance on its way, bringing in a young man involved in a high-speed motorcycle crash. He’s often alone, with no friends or family around.

If he’s lucky, he might have friends with him, but they’re usually paralysed by fear and despair, unable to make decisions during this critical moment. My team, ever ready and determined, prepares to receive the patient. Blood, tears, and the urgency of the moment set the stage for what could be a life-or-death resuscitation.

As an emergency physician, moments like these are routine, yet they never lose their gravity. Every time, I’m reminded of the incredible importance of the first 60 minutes after a traumatic injury—what we call the “golden hour.”

Why is the Golden Hour So Important?

The golden hour refers to the crucial first hour following a traumatic injury. In this narrow window of time, timely and effective medical intervention can save lives, prevent long-term disabilities, and maximize a patient’s chance of recovery.

After a road accident, the body is in turmoil. Blood loss, internal injuries, and shock can set in rapidly. Left unchecked, these conditions can quickly spiral out of control.

But when the right actions are taken when bleeding is stopped, an airway is cleared, or fractures are stabilized, the odds shift dramatically in favour of survival.

Take uncontrolled bleeding, for example. It’s one of the leading causes of death in road accidents. Severe blood loss doesn’t just weaken the body, it can kill within minutes.

But here’s the silver lining: it’s also one of the easiest problems to address. Something as basic as applying pressure or using a tourniquet can keep a victim alive long enough to reach the hospital.

Then there’s the airway, a lifeline, quite literally. Without oxygen, the brain and other vital organs can begin to fail in mere minutes. Clearing obstructions or assisting with breathing is often the difference between life and death.

Immobilising fractures, especially spinal injuries, is equally critical. Moving an accident victim improperly can cause irreversible damage, even paralysis. Proper stabilization prevents further harm and buys precious time for advanced care.

Finally, there’s transportation—arguably the most critical link in this chain. Getting a patient to a well-equipped trauma centre within the golden hour ensures they have access to time critical resuscitation, surgeries, intensive care, and the expertise needed to save their lives.

Bystanders: The Unsung Heroes of the Golden Hour

Here’s the thing: you don’t need a medical degree to save a life during the golden hour. Bystanders, often the first on the scene, play an invaluable role in those critical moments before professional help arrives.

If you witness a road accident, here’s what you can do:

• Call for Help Immediately: Dial emergency services and provide clear, concise information about the location and the nature of the accident.
• Resist the Urge to Move the Victim: Unless there’s an immediate danger, like a fire, don’t move the injured person. Movement can worsen spinal or internal injuries.
• Control Bleeding: If you see visible bleeding, act quickly. Use a clean cloth, your hands, or even a piece of clothing to apply firm pressure to the wound. If you know how, tie a tourniquet above the injury to stop severe bleeding.
• Stay Calm and Reassure: Your calmness can bring comfort to the victim and ensure you can think clearly to take the right steps.

A common hesitation among bystanders is fear—of doing something wrong, or even legal consequences. But the truth is, most countries, including India, have “Good Samaritan” laws to protect those who help accident victims. Acting with good intentions can save a life, and you are unlikely to face legal trouble for stepping in.

A Race Against Time

The golden hour is more than just a medical term; it’s a race against the clock. It’s a reminder that every second matters. As an emergency physician, I’ve seen countless lives saved simply because someone acted quickly—whether it was a friend rushing their loved one to the hospital, a bystander applying pressure to a wound, or first responders arriving on time.

These moments prove a simple truth: no one should lose their lives for lack of timely care. We all have a role to play in ensuring that accident victims get the help they need during the golden hour.

The next time you find yourself in such a situation, remember: your actions can rewrite someone’s story. Stay calm, act quickly, and be the hero someone desperately needs. After all, in the fight against trauma, every second truly counts.