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What Is The Golden Hour For Stroke Patients

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What Is The Golden Hour Stroke

Do you know about ‘The Golden Hour’ in Stroke ? Dr. Somanatha Vasudeva explains.

Stroke patients who reach the hospital within one hour of symptoms receive a clot-busting drug twice as often as those arriving later. Researchers call the first hour of symptom onset the golden hour. The study reinforces the importance of reacting quickly to stroke symptoms because time lost is brain lost.

Our Expert Explains Why It Is Important To Reach The Hospital Or Get Urgent Medical Help Within The Golden Hour Period

Written by Bhavyajyoti Chilukoti | Updated : October 28, 2017 10:05 AM IST

World Stroke Day is observed on the 29th of October every year. This year the theme is what is your reason for preventing a stroke?

Stroke is one of the leading causes of death and disability in the world. According to the World Stroke Organisation, every year 6.5 million deaths occur due to stroke. One in six people is likely to suffer from a stroke. Every 4 minutes a person suffers from a stroke, currently, there are an estimated 26 million survivors of stroke. However, the severity of the condition can be decreased by attaining medical help within the “Golden Hour”. So to help you out in understanding Golden Hour in stroke, Dr Rima Khanna, Associate Consultant-Neurology, Fortis Hospital, Shalimar Bagh explains the significance of the golden hour of stroke and how crucial it is to get treatment during this phase. Here are 6 lifestyle tips to prevent stroke.

A stroke takes place when the blood supply to a part of the brain is cut off. Without blood, brain cells get damaged and die. The severity of stroke depends on which part of the brain is affected and how quickly the person is treated. A stroke can affect a person s mobility, speech, ability to think, feel and analyse.

What Is The Golden Hour Ems

The first 60 minutes after traumatic injury has been termed the golden hour.1 The concept that definitive trauma care must be initiated within this 60-minute window has been promulgated, taught, and practiced for more than 3 decades the belief that injury outcomes improve with a reduction in time to definitive care

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What Are The Three Types Of Trauma

What is trauma?

  • Acute trauma: This results from a single stressful or dangerous event.
  • Chronic trauma: This results from repeated and prolonged exposure to highly stressful events. Examples include cases of child abuse, bullying, or domestic violence.
  • Complex trauma: This results from exposure to multiple traumatic events.

In Medicine What Is The Golden Hour

The golden hour is a window of opportunity in which rapid medical intervention can save a patient’s life or make a significant difference in the level of impairment a patient experiences after recovering from a medical emergency. People often use this term in the context of trauma medicine, where many members of the lay public are aware that rapid transport to a trauma center can make the difference between life and death, but it is also important for treatment of strokes, heart attacks, and other medical issues.

The hour in this case is actually more flexible than the slang term would have many people believe. For some medical issues, patients need critical medical attention in minutes, not an hour, or they will die. A classic example is a patient with an injury like a ruptured aortic aneurysm, where blood loss would kill the patient in far less than an hour. Other patients may recover well if they receive treatment between two and three hours after the incident, rather than in the first hour.

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Messages For The World Stroke Day

Observed on October 29 every year, World Stroke Day is the global awareness day established by World Stroke Organization to increase awareness and drive action on stroke around the world. With its #Precioustime campaign, the WSO aims to aware people of stroke signs and the benefits of timely access to emergency medical care.

Dr Gupta: Minutes can save lives & Stroke is Treatable, this is the message we are helping to promote on World Stroke Day. Early recognition makes a big difference and can lead to unbelievable outcomes during treatment. We encourage the public to recognize and learn the signs of stroke FAST and know to take immediate action.

Dr Venkitachalam: Stroke is a matter of concern and needs to be dealt with without any delay. Late arrival can cost one his/her life in case of a stroke. Early arrival can improve one’s quality of life.

What 4 Actions Should You Take After A First Aid Incident

  • First aid: 6 life-saving steps if youre first on the scene of an accident.
  • Step 1: Identify and mitigate potential dangers.
  • Step 2: Call for help.
  • Step 3: Check for a response.
  • Step 4: Check the casualtys airway.
  • Step 5: Check the casualty is breathing.
  • Step 6: Check the casualtys circulation.
  • Related resources.

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What Is A Stroke

Simply put, a stroke is what happens when blood flow to a part of the brain is cut off. Deprived of the oxygen that blood flow would ordinarily carry, brain cells in the affected region can die. There are two types of strokes. Ischemic or thrombotic strokes are most common, making up about 85 percent of strokes.

In an ischemic stroke, a blood clot blocks the flow of blood to one region of the brain, much like a foot on a garden hose blocks the flow of water. The rarer hemorrhagic stroke occurs when a blood vessel in the brain ruptures.

Time Lost Is Brain Lost

Importance of Golden Hour in Stroke Patient | World Stroke Day | RN Tagore, Kolkata

Many factors need to line up to ensure quick, effective and safe stroke treatment, said study co-author Dr. Jeffrey L. Saver, a professor of neurology and director of the Comprehensive Stroke Center at the David Geffen School of Medicine at UCLA.

“Time lost is brain lost in acute stroke,” Saver said. “A key message of this study is that the ‘Target: Stroke’ program enables hospitals to speed tPA treatment and improve patient outcomes. We hope that more U.S. hospitals caring for acute stroke patients will join this innovative and highly effective program.”

Researchers also found that more patients were able to be treated with tPA after the implementation of the initiative. Prior to the program, only 64.7 percent of eligible patients were treated with tPA. After initiation of “Target: Stroke,” this increased to 85.2 percent, said Fonarow, a member of the American Heart Association/American Stroke Association’s “Target: Stroke” committee.

Fonarow noted that treatment improvement was seen in all study patients. The median age of patients, who were evenly distributed between males and females, was 72. Almost three-quarters were white, 14 percent were black and 6 percent Hispanic.

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This Is Why The Golden Hour Matters

When it comes to a stroke, the sooner treatment is received, the more brain function can be preserved, and the permanent brain damage can be minimized.

“In case you delay the treatment then chances of permanent disability tend to increase. Thus, the 60 minutes after the onset of stroke symptoms are known as “the golden hour, and if the patient is treated during that period then he/she will be able to get back on track soon,” said Dr Anil Venkitachalam, Consultant Neurologist, Zen Multispeciality Hospital Chembur.

“Golden hour is vital as the medication administered shortly after the onset of symptoms tends to dissolve the blood clot that interrupts the flow of blood to the brain during an ischemic stroke. This medication is called tissue plasminogen activator, or tPA. It can be administered up to three hours after the onset of a stroke the sooner it is given the better. However, haemorrhagic stroke will be tackled with a different approach. The doctor is the best person to decide the suitable line of treatment for you. Every minute after the stroke is important for the victim as there is a continuous loss of neurons .

He suggested that awareness about the symptoms of stroke and importance of timely intervention should be made more prominent among the masses.

What Is The Golden Hour In Strokes Why Is It Important

Every year, 800,000 new strokes are reported in the U.S.

Strokes happen all the time, and yes, it can happen to you. Approximately 20 percent of stroke victims are between the ages of 20 and 55. Knowing the signs of stroke and acting quickly can make the difference between saving a life and a tragic outcome.

Stroke is the fifth leading cause of death and the leading cause of adult disability in the U.S. Unfortunately, few people know what a stroke is and how to recognize when a stroke is happening, according to the National Stroke Association.

But what medical professionals call the Golden Hour when someone is having a stroke can make all the difference in the world. The reason the first hour is golden is because stroke patients have a much greater chance of surviving and avoiding long-term brain damage if they arrive at the hospital and receive treatment with a clot-busting drug called TPA within that first hour.

Time saved is brain saved, says Charlotte Colbert RN, who is the INTEGRIS Health stroke community educator. Time lost is brain lost. Thats why recognizing the signs of stroke is so important. Immediately knowing what to do when someone is having a stroke can save someones life and help them avoid brain damage. If you suspect someone is having a stroke, the absolute first thing to do is call 9-1-1, she says.

Time is of the essence. I cant stress that enough,” says Colbert.

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What Is Considered A Stroke

A stroke occurs when blood flow to an area of the brain is cut off, causing brain cells to be deprived of oxygen and die. A stroke can cause life-altering, devastating changes like loss of speech, movement and memory.

Stroke is a SUDDEN onset of symptoms when just a minute ago a person was fine, Colbert says. There are two major types of strokes, but each one is treated differently.

The most common type of stroke is an Ischemic Stroke, which causes a loss of oxygen to the brain due to a blockage of a vessel in the brain. Roughly 85 to 88 percent of strokes fall under this category.

Its so important to get treatment immediately for Ischemic Stroke because we now have a clot-buster called TPA . Its an enzyme drug that can dissolve clots, and any stroke-ready hospital can administer it, says Colbert.

A hemorrhagic stroke is rarer but is caused when a blood vessel ruptures in the brain. High blood pressure is the number one cause of hemorrhagic strokes.

When you arrive at the hospital, the ER will immediately order a CAT scan to see what type of stroke you are having, Colbert says. Thats why you shouldnt give someone having a stroke an aspirin. If they are having a brain bleed, it could make it worse.

Faster Treatment Better Outcomes

2013.stroke areyouready

The researchers report that at participating hospitals, the average time it took to deliver tPA to patients fell from 74 minutes to 59 minutes. This speedier treatment, they said, was accompanied by improved outcomes, including reduced mortality, fewer treatment complications and a greater likelihood that patients would go home after leaving the hospital instead of being referred to a skilled nursing facility for advanced rehabilitation.

“These findings reinforce the importance and clinical benefits of faster administration of intravenous tPA. Through this national initiative, more patients were able to be treated with this beneficial therapy and in a safer, more effective fashion,” said first author Dr. Gregg C. Fonarow, UCLA’s Eliot Corday Professor of Cardiovascular Medicine and Science and director of the AhmansonUCLA Cardiomyopathy Center at the David Geffen School of Medicine at UCLA.

The benefits of tPA in acute ischemic stroke are highly time-dependent, and for more than a decade, guidelines have recommended administering the treatment within 60 minutes of hospital arrival. Yet despite the evidence, recommendations and prior efforts, a previous study by the team found that less than 30 percent of eligible patients were receiving the medication in that first hour.

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Golden Hour Thrombolysis In Acute Ischemic Stroke: The Changing Pattern In South Korea

aDepartment of Neurology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea

bClinical Research Center, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

cDepartment of Neurology, Cerebrovascular Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea

dDepartment of Neurology, Nowon Eulji Medical Center, Eulji University, Seoul, Korea

eDepartment of Neurology, Daejeon Eulji Medical Center, Eulji University, Daejeon, Korea

fDepartment of Neurology, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Korea

gDepartment of Neurology, Seoul Medical Center, Seoul, Korea

hDepartment of Neurology, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea

iDepartment of Neurology, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea

jDepartment of Neurology, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea

Dear Sir:

The Golden Hour In Heart Attack Patients

When a person has a heart attack, the first 60 minutes are decisive. The heart muscles start dying if they have no blood supply in the first 80-90 minutes. Therefore, depending on the degree of damage, doctors can opt for medical management , stent placement, or bypass surgery to re-establish the normal blood flow as soon as possible. The earlier a patient receives a thrombolytic treatment after a heart attack, the higher the chance that they will survive and have less heart damage.

To summarize, the golden hour often means as soon as possible. Good judgment calls are always essential in trauma and emergency care.

  • For some patients, for example, those with anaphylaxis , the golden hour is only a few minutes, or they may die.
  • For road traffic accidents with amputations of the hands or fingers, the sooner the parts can be attached, the better. This must be done within a maximum of 6 hours of injury, or the digit or body part will die.
  • Re-establishing of the blood flow for the damaged heart muscle in a heart attack is advised within 1.5 hours of symptom onset to avoid death of the heart cells.
  • Although field intubation can be a good thing, it may not always be the correct thing to do if it will take a long time and eventually delay reaching the hospital.

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When It’s A Matter Of Life And Death Every Second Matters But It Is The Time In Hand That Helps A Person To Decide What Needs To Be Done Next

Written by ANI | Published : February 16, 2018 4:31 PM IST

When it’s a matter of life and death, every second matters. But it is the time in hand that helps a person to decide what needs to be done next. There is a huge difference what one should or can do when a person has an hour to save someone’s life compared to when a person has only got seconds. What course of action one should take changes drastically in the two scenarios. The difference between having a golden hour and having golden seconds to save a life is almost the same difference as that of suffering a heart attack and suffering a sudden cardiac arrest.

The Golden Hour in Emergency Medicine

“The concept of the golden hour is the vital time period of up to one hour by which a patient suffering from traumatic injury or medical emergency should be receiving proper medical assistance to prevent death or irreparable damage to other body parts and organs. Although nothing is set in stone, but the chances to save a patient are usually really high if he receives due medical attention within an hour of the traumatic event,” said Dr. Vanita Arora, Senior Consultant, Cardiac Electrophysiologist & Interventional Cardiologist, Max Super Speciality Hospital.

Significance Of Golden Hour In Stroke

Responding to Golden Hour Emergencies: Early Phases Acute Stroke/Acute Ischemic Stroke Care – MED-ED

Stroke is a leading cause of serious long-term disability and mortality. According to the Indian Stroke Association, the incidence of stroke in India has increased by almost 100 percent in the past few decades. Around 1.8 million people in India suffer from stroke every year. Identifying the early signs and symptoms and getting treatment within the first four and a half hours after the onset is crucial. A delay in seeking the right treatment can lead to disability or death.

Stroke arises when there is a blockage or rupture of the blood vessels in the brain. Lack of oxygen and essential nutrients in the brain can lead to the death of brain cells that brings in serious problems. Since the brain controls each and every action, any disturbances can hamper the brains function. A brain stroke can happen anytime irrespective of age, gender and can affect the ability to move, speak, eat, cognitive abilities, and control over your own body.

Stroke is a state of Medical Emergency

Ischemic Stroke is the most common type, around 85 to 88 percent of strokes fall under this category which causes loss of oxygen to the brain due to a blockage of a vessel in the brain. Over time, high blood pressure can lead to the rupture of blood vessels in the brain. This is called a hemorrhagic stroke which is rare. It is important for patients to get proper medical evaluations done at the hospital to identify the types of stroke they are having.

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