The Golden Hour, Bermuda, 2010
Before I took my EMT training course, I had only heard the term “golden hour” as it’s used in filmmaking. In cinematography and photography, the “golden hour” is the first hour after dawn or the last hour before dusk when the light becomes very fine. It has to do with the sun being so low on the horizon and because it’s indirect, it casts long shadows and there is some kind of filtering effect that adds colorful qualities and tinted hues. The evening “golden hour” often culminates in a beautiful sunset, but even when it doesn’t, there is usually a very rare atmosphere that makes everything look a little better. Filmmakers will spend hours, sometimes days preparing cameras, equipment and actors for a scene that calls for the “golden hour.” I’ve always loved the term, it’s beautiful to me, there’s something magical about it. Denis and I will sometimes just say it, if we’re on the beach at the right moment or the light is hitting a building in an old city, late in the day, “It’s the golden hour.”
Last spring during my EMT training, I learned of the medical meaning of the “golden hour”, which is really what pre-hospital emergency care is all about. Dr. R Adams Cowley, an American military physician, and one of the pioneers of our modern EMS services, wrote, “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 three days or two weeks later — but something has happened in your body that is irreparable.”
The golden hour in medicine, as in photography, is not meant to be taken too literally, it may be more or less than an hour, but the idea, in both, is that it’s a very precious time; that there’s not a moment to waste.
Apparently it was during World War I that French military surgeons became aware of the “golden hour” concept. Later, during the Vietnam War, the need for trained medical personnel to be able to treat trauma victims in the field rather than just transport them to the closest hospital became standard protocol. In fact, practices of the military field medics in the Vietnam War were the model upon which the modern American pre-hospital emergency care system was developed.
As recently as the 1960s, ambulances were basically just vehicles that were used to transport patients to the hospital. The drivers usually had no medical training, in fact, they were often undertakers. Since hearses were sometimes the only vehicles in a community that could accommodate a person lying flat, many undertakers moonlighted by picking up the sick and injured and driving them to the hospital
The need for improved and standardized pre-hospital emergency care was illuminated, in large part, by a report written in 1966 called the White Paper. Click on the link, it’s pretty interesting.
Before I took the EMT course, I assumed that, once I became certified, I would be able to save a person when called to the scene of a cardiac arrest. What I learned was that, in fact, by the time an EMT or medic arrives it’s usually too late. I was told that it was unlikely I would ever save somebody’s life by performing CPR as an EMT, but I had a very good chance of saving somebody’s life performing CPR as a good-Samaritan – that is, as just a person who happens to be there when another has a heart-attack. That’s why everybody should know CPR. It’s those golden minutes that make all the difference. And the same applies to basic first aid. Could you stop an arterial bleed if necessary? Could you stabilize a person’s neck and spine while awaiting an ambulance? You don’t have to be a certified medical technician to know these skills, and they can be magic. They’re golden.
Ann,
Great post!!!! I have never heard of it in the film industry…
I know of the Golden Hour in the medical sense and is the threshold of life or death in a medical emergency…
In my 30 yrs of working in the medical field, the Golden Hour has never changed, everything is a gray area with constant changes due to learning more about diseases, causes and treatments…
What a wonderful post, so full of information. Thank you for all of it. Such important facts. And you are so right–knowing CPR is basic and potentially life saving; and who wouldn’t want to be able to save a life?
It really would be a wonderful thing to be well informed, I know when my dad visited me in the USA for Christmas in 2005, he had a heart attack at 9 am on December 22nd He came to make his coffee at 8.30 and said I don’t feel well and took himself upstairs…within minutes all hell broke loose and all i could do was try not to panic and call 911, within minutes we had a yard full of ambulances and paramedics, he was at the local hospital within 20 mins and then airlifted to UMASS within the hour by the time i drove and got to UMASS at 11 am he had already had heart surgery…. Someone saved his life that day, it wasn’t me, but wow I was very impressed at the care he got… He has been doing great since, I did feel very very helpless, Until I got to UMASS i had no clue if he had survived…. I need to read up!
Wow, what an amazing story Bev, glad he’s okay now.
WOW, yes! Bev, so glad he got great care and is OK!
Ann- Thank you so much for the post.Glad to know we can each make a huge difference if we are informed.Has being an EMT changed your outlook about doing so? I could see why maybe feeling more helpless than you thought at times?? What an interesting way to put it. I have some questions- have you ever delivered a baby other than your own LOl? What’s the strangest thing you have encountered on the job? How do they let you know when and where to go? Are you on a certain shift a month/day/week? How many are in your dept? Why/how did you decide to become one?
What a great thing you do no matter how little or great the task is. I would bet your kids and Denis are very proud of you. Hang in there with the snow- I’m sure it gets pretty scary when you get called out and every minute counts.
Thanks again for posting this.You are truly a remarkable person.Have a great evening! xxoo
Kristin, it’s funny you ask about delivering babies, because going into the course that was the class I was most looking forward to and I thought how great it would be to actually deliver a baby. The obstetrics class covered so many things that can go wrong during childbirth that not only did I not want to deliver anybody else’s baby, but I couldn’t believe I had ever embarked on an endeavor as dangerous as childbirth myself! But like many things I learned, what I thought was the most scary thing – the cord wrapped around the baby’s neck, is actually rather common and very easily dealt with in most cases. It was the things I had never considered (baby’s arm coming out first) that made me realize how precarious childbirth can be.
I don’t have any great stories, I’ve really not been doing it long enough and the few rather interesting calls are sort of specific and I can’t really write about them because of privacy issues. We have a very devoted crew of volunteers in our town and if you hear a call and can respond, you do. At night, we’ve started doing shifts where one “squad” will be on duty every night for a week. It’s nice because you can turn off your radio if you need a good night’s sleep and know that there are people who are ready to respond.
Thanks so much for responding. I’m not surprised about the risks with childbirth. Both of my boys were almost 11 lbs. each, and no c-section for me.My neighbor who is a delivery nurse said that there are just as many big babies in NIC units as there are preemies. The risks with big babies are huge, but I’m tall so my doc said I would be fine and I was, thank God!
I’m glad that you guys have organized your schedules so you can really focus when you can do so. I think it would be a fun job in a way, especially helping with whatever random things there may be. Too bad there isn’t one here, but of course Mpls is a big city. How was your family about it? Were they surprised or was it something you planned on doing for a long time? I know both of your kids are at college now, so maybe that opened up some time?
I usually read and enjoy all the comments on Ann’s posts. However, two babies of almost 11 lbs each has stopped me in my tracks and I think I’ll give it a miss today and go and have a lie down!
Too funny! I said the same thing myself! My oldest son was almost dropped on the floor when he was delivered. There was an intern helping my doc and he literally almost dropped him! It was very funny since he didn’t know what to do with himself. I’m sure he will never forget it
I certainly learned a lot reading your post today. Very interesting. And if you took that pic, your giving MP a run for the money, it is truly beautiful.
I learned first aid while in the Army
We also learned other things more Battle specific
Like how to carry your wounded buddy off the field into safety
They actually taught us a way to carry someone off the field who may out weigh you by 100 pounds
Being a small thing of 130 pounds(years ago) I carried my 200 pound Drill Sergent during a drill.
I really loved that course
Tammy, can you explain how you go about carrying a grown person or is it something that you have to demonstrate? We were taught to use our legs and lift everything close to the body, but all our lifting involves at least one other person.
Any fireman or soldier can demonstrate the fireman’s carry for you. In college, my boyfriend was teaching me self-defense he had learned in ROTC and as part of this he showed my the fireman’s carry. Basically, you carry the person on your shoulders with the arms holding the arms and legs. Of course, it helps to be a Marine.
Here are some pictures.
http://www.google.com/images?client=firefox-a&rls=org.mozilla:en-US:official&channel=s&hl=en&q=fireman%27s+carry&um=1&ie=UTF-8&source=univ&ei=8blATfHoCdPAgQeRy-TcAg&sa=X&oi=image_result_group&ct=title&resnum=2&ved=0CCkQsAQwAQ&biw=852&bih=410
From you tube: soldiers race using the fireman’s carry.
http://www.youtube.com/watch?v=uVOtoL3WAdo
Fascinating stuff.
And finally, I’m not the last to the party! (ie, last to comment!)
I’m so glad, because I have an important question that maybe Ann or one of my fellow bloggers can help with.
I agree that it’s so important for “civilians” to know CPR and general trauma care to assist before an ambulance arrives. In Eventing, we now all have to wear medical armbands so a judge or show official can have all of our information (personal and medical) at their fingertips, in case the rider is knocked unconscious (which yes, happened to me at an event).
As a riding instructor, the day will come when someone will fall from a horse and it may be serious, or someone may just be on my property or at Akindale and haave a critical health issue.
So, here’s my question: Where does one go to find a local program to learn CPR and other live saving techniques?
Great post, Ann. Thanks.
KC, most hospitals offer CPR courses regularly and most communities do as well. Does your town have a volunteer ambulance service? They would be the people to contact.
It only takes a few hours to take the CPR course and then you’re certified and everybody should really do this. The Heimlich maneuver is also very easily learned and I think I was taught this at the CPR class.
If I were you, I would go on YouTube and see if there are any basic first-aid training videos. Stopping bleeding by applying direct pressure to the wound is something that you probably know from taking care of horses. If somebody falls and breaks a bone, obviously, it’s very important to keep the person from moving if possible, until the ambulance arrives and also to keep the person warm because they will likely be in shock after a serious injury. We both know that there’s no end to the possible injuries that happen when you’re on and around a horse, so it’s just important to use common sense and make sure that you always have a phone handy to call 911.
Excellent advice. We don’t have a volunteer ambulace service, but we do have a volunteer fire dept., so maybe I’ll give them a ring and ask if they have any programs. YouTube is also a good source.
It’s funny, I feel so prepared in the event of a horse injury or illness – and have acted under fire with calm and common sense (I have a photo from an Akindale horse who, last week, had a laceration in her face down to her nasal cavity that would make you gasp). But with people, I feel completely clumsy and unprepared. Perhaps it’s because they can talk back to me…!
I do usually have the house phone out at the barn when teaching just in case I need to dial 911, and of course, everyone wears proper attire – no excuses. But being able to handle a huge (human) medical crisis would really be a good thing.
(And, just talked to Matt – he thinks it’s a great idea and suggested we go together.)
Thank you!
KC, you can also check with the Red Cross. I took CPR and First Aid through them at a local hospital.
Your local YMCA is also a great source for basic first aid to full-blown certifications for CPR & various levels of lifeguarding.
Wow. These posts are a wake-up call for me. I’m going to find a CPR class, and will educate myself better in case Im ever involved in some sort of an emergency. I’ve only once had to assist someone, and it was simply an elderly man who fell in a parking lot, and had cut his knees pretty badly. He was taking a blood thinner, so the blood flowed too freely. I actually faint at the sight of blood, but something took over me, and I held tissues on his leg until the bleeding stopped. I know it’s probably a pretty wimpy story, but if you knew how faint I got at the sight of, or even the word “blood,” you’d understand how incredible it was for me to help the poor man.
So, I’ll go off to find a class right now.
Thanks for the great post, Ann, and all the other posters. Bev, your story is an incredible one. I’m so happy to hear that your father got through it!
Ais, I think to that old man, you were a hero.
Hell, KC, we’re dating.
Ais, I needed that laugh. You’re just so darn funny!
aislinn, i so didn’t see that coming – hilarious!
Ais – LOL.
The same thing happened to my ex boyfriend (a soap actor) and I on the West Side Highway – an old guy crashed his car into some scaffolding, we stopped, got the paramedics and then gave the guy a lift home.
He was a priest.
He gave us a box fan (from his car) as a thank you.
We did not date. Although he had a better personality than soap opera dude (who couldn’t act his way out of a paper bag but he was fun to look at).
KC, not exactly The Thorn Birds, eh? Darn. (You’re too young to remember The Thorn Birds. Sigh.)
KC’s post about the armbands that eventing riders wear in case they have an accident and become unconscious reminded me of this great app available for iPhones and I’m sure there’s something similar for other phones. The iPhone app is called “ICE” (In Case of Emergency). It stores all your emergency contact information, your blood type, any allergies, etc.on your phone. If you have an accident and are unconscious, EMTs know to look for this on the way to the hospital and it can really help you. Here’s a link:
http://www.ems-options.com/smart-ICE.html
That’s great! I didn’t know about that app — I’m downloading it today and will tell family and friends about it, too.
CT residents might have heard that this storm is being called “Winter Storm Denis” after Denis. You can’t believe the outraged phone calls we’ve received today. People seem to want to blame him.
http://dennishouse.wordpress.com/2011/01/26/snow-storm-named-after-actor-denis-leary/
That’s hilarious! I didn’t really think they’d do it.
Let’s hope that just this once Denis is a tempest in a teapot.
Thanks for the link to the article, Ann…People are actually annoyed with the Learys over this… Really?!
HA!! So funny, I wasn’t sure if you were kidding when you posted about this earlier in the week.
My, how glam you look in the photo on that link!
I am here in northeastern NJ, after a very long commute home tonight, hoping for a snow day tomorrow. the snow is so much more fun when you can just cocoon in your house, cook a nice meal and not worry about having to drive.
Hope all stay warm and dry tonight.
The Red Cross teaches both CPR and first aid. If you belong to a group they will come to the group and teach everyone for a small fee.
Oh Sandy, of course! The Red Cross. Thanks.
I will see if i can find some pictures
you had to do it over your shoulders something about weight distribution.
Mind you it was for battle field rescues so it could just be you and your buddy that you are trying to save.
I was amazed it worked
I am sure I still have the manuals somewhere
Yes I am a secret hoarder
So If I cant find it on internet I will try take a picture
Found it
http://en.wikipedia.org/wiki/Fireman's_carry
In art, the golden hour is also termed “Greek light” or “the blue hour,” the Mediterranean version.
Oh! That is pretty too
I hope you all are surviving Denis…the storm, that is.
Ann, thanks for the post. I need to refresh my CPR/First Aid knowledge. I live alone, so I’m also training my cats. Riley knows how to pounce on my chest at any given moment, so I feel she will be a natural at giving me the heimlich or chest compressions when. And Ziva seems to know how to pull air out of my lungs during the night (we wake up nose to snout sometimes), so it shouldn’t be too hard to get her to reverse action to accomplish mouth-to-mouth. With a little team work I think they could save me.
Cat, you are a pistol!
Hilarious, Cat! How lucky you are to live with such talented felines.
Ann your posts are so meaningful and inspiring. What happens to the body that it’s too late in that short time? Just the trauma? I took first aid years ago but now this is making me think i need a refresher!
I just adore your blog Ann! I’ve taken to reading your posts outloud to my hubby who equally enjoys. Thank you and keep on writing Ann!
Cupcake
http://Www.thefamily-table.blogspot.com
Cupcake, I hope any doctors or nurses will free to offer up a more detailed medical explanation for this. I think there are various reasons. Obviously, in that first hour, you can take steps to stop bleeding, treat for shock, stabilize broken bones so that they don’t cause damage to nerves or arteries. Also, on the way to the hospital, you are monitoring the person’s vitals – pulse/blood-pressure and you can see if the person is improving or not and if they’re deteriorating you can try to figure out what is happening. Gaining the person’s medical history and other important data all saves time. Once the person arrives at the hospital all that info has been reported in from the ambulance and they can go right into surgery or other treatments. If a person’s body has gone into shock because of internal bleeding, and they aren’t stabilized immediately, they can treat them later at the hospital, but the damage might have already been too much. There are also medical emergencies like stroke, heart attacks and allergic reactions that are very time-sensitive and if you had to wait to treat at the hospital, it would be too late.
Ann, I really respect your compassion and empathy towards your neighbor. Aislinn, you truly were a hero to that man in distress. A calm presence, a soothing word, a tender touch – why, that means so much to someone who is suffering with their health. And then of course, comes the “competent” piece – knowing CPR and first aid – and based on your education and skill set – responding to the critical health needs of the person before you. It is an awesome responsibilty and a real privilege to affect the health (in a good way) of someone else. I really enjoyed reading the great posts and recognize the warmth and kindness of those who come to this blog.
I took the Office of emergency managment’s Community Emergency Response Team course, and it was inspiring and illuminating. It is a 12 week course, one night a week. This week I took a brush up CPR class, and I was thinking that the sequence of 2 breathes and 30 chest compressions should be passes around. I see all these jackholes with tattoos of M and M’s or unicorns, but having a tattoo reminding us on how to save a life, that would make sense. I’m not a tattoo person, but I did sharpie 2/30 on my leather gloves.
Thank you for cultivating such a bright spot, you are dazzling!
Ann, thanks for this post. Learning CPR has been on my “to do” list for too long. In 1979, when I was 17 years old and a senior in high school, my father was sent to the hospital emergency room because he started vomiting at work. While in the emergency room, he had a massive heart attack, which would have killed him if it had happened anywhere else. His life was saved because this happened in the emergency room, and I am so grateful for the extra 21 years I got to have him on this earth.
Thanks again for the info, and this post.
this makes me thankful and more than a little nostalgic for my years as a lifeguard. it was literally the only job i’ve ever had in my life that gave me any sense of fulfillment at all. i felt like i was actually DOING something that mattered.
cheers to you, Ann, for taking the course and volunteering to do this. the value for you and your community cannot be overestimated!
as an aside, do they actually teach the “Stayin’ Alive” method(?) when teaching CPR now? i learned CPR 17 years ago, before all that razzmatazz…we just counted. *shrug*
This story reminds me of something that happened when my son came home from the hospital. He was l lb 12 oz at birth and came home at 4 lb 4 oz about 3 months later. We practiced CPR for weeks because of the perceived tendency of premature babies to suffer SIDS. The kicker came just before he was released when the nurses warned us about something. Even if the home heart monitor alerts you immediately, often you aren’t able to interrupt the SIDS episode regardless of what you do. They had just had a kid die two weeks after going home after being in their care for 4 months. Talk about a sinking feeling in the pit of your stomach.
Oh Jip, I remember those first days home from the hospital with Jack. I had been told that the reason babies never die from SIDS while being held is because your breathing stimulates theirs. So I slept with him on my chest, or semi-slept. Such a long time ago now, but memories like that are so real they feel like yesterday.
Very interesting to know! Even though I had a CPR course, I think I would just be too nervous or jittery when the actual situation would happen…..
And very beautiful picture! The “golden hour” is actually my facvorite time for NYC – I used to love seeing the city when the sun just came up, because it made it look so nice- – streets were still empty and the rose color of the sun made the buildings and the city look so much nicer then let’s say during rush hour.
Well, Winter Storm Denis certainly packed a wallop last night.
Thanks, Denis. Now, please go away, will ya.
Great post Ann, with much follow info.
Everyone, if you ever leave your house, or have children, or others living with you, take Ann’s advise and learn basic first aid. Twice I’ve performed the Heimlich Maneuver, and both times the person had been choking long enough to have changed colors. No paramedic would have made it in time. Seeing this will send you into action if you have been trained.
Ann, thanks for the iphone app.
Aislinn, You and the old man make such a cute, (strange), couple.
Cat, I swear, KC can come teach your cats to do anything. Her cats up the toilet! (But they are too lazy to do the dishes)
Sorry, her cats USE the toilet
I am told I nearly did not make my second birthday. We were in the car on a trip and my mother was feeding me a piece of fruit and I choked. I was turning blue, my sister said. My mother told my father to stop the car and she jumped outside and dangled me by my feet while she was hit my back, dislodging the piece of plum. It was decades later when she learned she had done the right thing for an infant, but it was just instinct back then.
Thank you for another beautiful photo. I really appreciated the content of this post. I felt I learned something new today. Thanks.
While Denis rode out Storm Denis in sunny California we in CT were hit with a doozie!! It is beautiful, though, and I will keep that thought as I dig my way out of the house. Be safe, Ann, when you feed and water your horses. Can you still get to the barn?
Fantastic post. That last paragraph is SO important!
And what a beautiful photo, so glorious and serene.
Ann, thank you for this lovely message and photos. I took a CPR course today to get certified and read your post early this morning before I left for the class. Talk about timely. Years ago, a colleague and I kept a man alive while the ambulance was on its way–he was a janitor at the school where I was a teacher and that feeling has stayed with me, so “The Golden Hour” information really touched my heart. Thanks so very much, Ann, for touching my heart today.
Ann,
I’m new to your blog, and I’m really enjoying it! You are an excellent writer and photographer, and I particularly get a kick out of the
titles!
I’ve been much more interested in emergency response since developing food allergies in 2008 (when I was 27, almost 28, years old). I carry two epi pens and Benadryl at all times, in case of a severe reaction. Thankfully, I’ve never had to use an epi pen, and I hope I never will. While reading the comments, I thought of something that I’d never considered before. While dining out, it would be very easy for someone to mistake an allergic reaction for choking! I think they’re ugly as all get out, but I really ought to be better about wearing my medical ID bracelet (which, at the time being, I only wear when I’m traveling alone). I would not want someone to use the Heimlich on me, when what I’d really need is an epi pen to the thigh.
On another note: For people who do not have iPhones, simply type ICE into your phone’s address book (with your emergency contact’s phone number). Everyone should have an ICE on their cell!
Have a great week!
Lindsay
A belated thanks for your comment Lindsey and that’s useful information about the ICE on your contacts number.
i highly recommend Road ID, as well. Similar in basic function to the phone app, all of your medical history, medications, emergency contact info & the names & numbers of your doctors are available to first responders & hospitals. You wear it like a watch band or dog tag or tied into your shoe laces. I wear mine except when I go to bed at the end of the day. it’s great for kids & the elderly who might not carry cell phones; it’s great for when you’re swimming, running, biking – at the beach w/o your phone on you. There’re many scenarios when I’m w/o my phone, or I have it but the battery’s dead, or leave it in my car , in the gym locker, etc. My Road ID is always right on my body.
RoadID.com
Great post, Ann. As usual