Real-Time Medical Care

Medical care is often portrayed on television and in the movies as a race against the clock. In real life, however, most medical treatment can safely proceed at a decidedly slower—and less exciting—pace.

There are a few exceptions, of course, where the "need for speed" can mean the difference between life and death. For example, cardiac arrest (when the heart stops) and respiratory arrest (when breathing stops) require immediate care. This may include mouth-to-mouth resuscitation, chest compressions, and sometimes electrical shocks to the chest. These help keep oxygen flowing to the brain and restore a normal heart rhythm, at least until the victim can be taken to a hospital.

But treatments for most other conditions need time to work. It's important to be realistic about how soon you can expect to feel better or to see your condition improve. If you expect immediate relief, you might be tempted to stop treatment before it has a chance to work.

When speed matters

Only a few of the most common causes of death in the United States require urgent treatment.

• Heart attack—Minutes count when a person is having a major heart attack. Standard guidelines recommend a procedure (called percutaneous coronary intervention, or PCI) to open up blocked coronary arteries if fewer than 12 hours have passed since the start of symptoms and if PCI can be performed by experienced physicians within 90 minutes of arrival at the hospital.

• Stroke—As with heart attacks, minutes matter in stroke; if blood flow to the brain is cut off for even a few minutes, brain damage usually occurs. A clot-busting medication may reduce brain injury during a stroke if given within three hours after symptoms begin. If not, the drug works poorly or not at all.

• Accidental injury—Major trauma requires urgent treatment. Emergency medical personnel often refer to "the golden hour," the 60 minutes following major injury (especially when there is internal bleeding) during which victims must be stabilized, transported to a hospital and treated to maximize chances for survival. While the notion of a "golden hour" has been called into question, it's clearly true that the sooner trauma victims get definitive care, the better. In fact, following a critical injury, seconds count. Surgery to stop internal bleeding, repair damaged organs, support breathing and heart function are truly life-saving. Delay for even a few minutes may reduce the chances of survival.

• Bloodstream infection (septicemia)—People with serious, body-wide infections need antibiotics and other supportive measures right away. A delay of minutes or hours may make the difference between survival and death.