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3,600 critical seconds in medical emergencies

Speed is critical when it comes to seeking medical help for life-threatening conditions such as heart attack, stroke or severe trauma.
Speed is critical when it comes to seeking medical help for life-threatening conditions such as heart attack, stroke or severe trauma. PHOTOS: MOUNT ELIZABETH HOSPITALS

For urgent medical conditions, make your way to the nearest Accident & Emergency (A&E) department as soon as possible

It is the golden hour — the precious 3,600 seconds that must never be wasted.

Dr R Adams Cowley, who was a prominent American trauma surgeon and emergency medicine physician, said: “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.”

Timing is critical when it comes to seeking medical help for life-threatening conditions such as heart attack, stroke, seizures, severe trauma and the loss of consciousness. 

For people with pre-existing illnesses or chronic conditions, Dr Vivian Chan, a senior resident physician at the Accident and Emergency Department of Mount Elizabeth Hospital, said: “It’s important to know the potential complications that can arise from your condition and also the symptoms that can arise from the complications. That way, you are prepared and know when to call for an ambulance or when to go to the A&E to seek medical treatment.”


Should you experience symptoms of a possible heart attack, call for an ambulance immediately.

Heart attacks

Dr Chan cited an example of patients with heart conditions. She said that having chest pains with cold sweats may be a sign of a heart attack.

If patients are prepared, they could quickly take an aspirin or have rescue medications such as a nitroglycerin (GTN) tab or spray to use under the tongue to open up the coronary vessels. This buys them time while the ambulance is on the way.

Dr Leow Khang Leng, an interventional cardiologist from Mount Elizabeth Novena Hospital, said: “A heart attack happens when the flow of blood to the heart is suddenly blocked by a blood clot. This causes the heart muscle to die due to the lack of oxygen. A heart attack is considered a medical emergency and can be fatal if left untreated.”

Should you experience symptoms of a possible heart attack, call for an ambulance immediately, or quickly make your way to the A&E department at the nearest hospital.

If blood flow is not restored to your heart muscle within 20 to 40 minutes, irreversible death of the muscle begins to occur.

Dr Leow said: “The optimal window of survival for a heart attack is within the first three hours after the first onset of a heart attack symptom. If treatment is delivered within three to four hours, permanent muscle damage can be avoided. However, if treatment is delayed beyond 12 hours, the damage is usually irreversible.”


A gallbladder attack occurs when there is blockage to the flow of bile and as a result, the bile then accumulates in the gallbladder.

Gallbladder attacks

While having gallstones may be rather common, not all gallstones have symptoms or complications. 

But how will you know if your sudden severe stomach pain is actually a gallbladder attack?

Dr Foo Chek Siang, a general surgeon at Mount Elizabeth Novena Hospital, said: “This pain is typically located in the upper abdomen, either in the centre between both ribcages or just below the right ribcage. 

“This pain can occasionally radiate to the right shoulder or to the back. It can either be intermittent or constant in this case. There can also be chills or a fever in the presence of an acute infection.”

A gallbladder attack occurs when there is blockage to the flow of bile and as a result, the bile then accumulates in the gallbladder.

Urgent surgery, such as partial or complete gallbladder removal, prevents complications like gallbladder rupture where bile leaks into the abdominal cavity. This bile leakage may potentially lead to sepsis, which is a life-threatening condition.


Once a bone fracture is suspected, it is important to protect the injured part of the body and to get a consultation with an orthopaedic specialist as soon as possible.

Broken bones

Broken bones, or fractures, can occur with traumatic injuries such as falls or in sports injuries. There is usually severe pain and the person would not be able to move the injured part at all.

Once a fracture is suspected, it is important to protect the injured part of the body and to get a consultation with an orthopaedic specialist as soon as possible to prevent long-term complications or permanent deformities.

How do we recognise a bone fracture and how can we prevent the injury from worsening?

Dr Victor Seah, an orthopaedic surgeon at Mount Elizabeth Novena Hospital, said that a bone is likely to be fractured if there is an obvious deformity — an awkward angle of the limb or an abnormally shaped joint after an injury.

For upper limb injuries, it is best to immobilise the upper limb in a makeshift arm sling if possible.

In a lower limb injury, such as the ankle, if the person is not able to put any weight at all on the injured area, it is highly likely that the bone may be fractured. Refrain from using the injured limb and get support with the help of crutches, a walking aid or a wheelchair.   

For more information, visit www.mountelizabeth.com.sg or call 6250-0000 (Orchard) or 6898-6898 (Novena) to make an appointment with the specialists. For Mount Elizabeth ambulance service which provides emergency and non-emergency medical transportation, please call 6473-2222.

This article provides general information only and is not a substitute for medical advice. Please consult medical or healthcare professionals for advice on health-related matters.