Azharuddin’s son Ayazuddin a victim of missed resuscitation during the Golden Hour?

7:57 am Health Care, Medicine, Social Health Community

Ayazuddin (19), son of former cricketer and Moradabad MP Mohammad Azharuddin, died on 16th September (2011) five days after being critically injured in a road accident in Hyderabad. He was critically injured when his 1000 CC Suzuki skidded on the Outer Ring Road at Puppalguda on Sunday. His cousin died on the same day.

Ayazuddin suffered a cardiac arrest on his way to the hospital. He responded to resuscitation and was later operated on to stop the bleeding from his lung and kidney. His kidneys were also damaged. Commuters on the route alerted the police and a patrol vehicle from a nearby police station arrived soon. The police team failed to get an ambulance and had to take the profusely bleeding cousins in their patrol vehicle to the hospital, losing an hour in the process.

Medically the lesson is that opportunity to save him was list as the precious first hour was missed of resuscitation.  The “Golden Hour” concept emphasizes the increased risk of death and the need for rapid intervention during the first hour of care following major trauma. Rapid intervention improves the outcome of injured patients (obstructed airway, tension pneumothorax, severe hemorrhage).

Death in road traffic accident can be a part of trimodal distribution of mortality (death at the scene; death 1 to 4 hours after injury; and death weeks later, generally in an intensive care setting) or bimodal distribution (death at the scene or within the first 4 hours).

The current thinking is that relatively few patients die after the first 24 hours following injury. The large majority of deaths occurs either at the scene or within the first four hours after the patient reaches a trauma center. This is true only when the patient gets medical care within the first hour. The care involves fluid resuscitation and control of the bleeding.

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