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5 medical conditions to treat immediately

Get help fast for a stroke, puncture wound, and more

Consumer Reports on Health: June 29, 2014 06:00 AM

You may have heard of the “golden hour,” that short window of time when medical attention must be administered for an injury or illness. Once the window closes, the chances of successful treatment diminish greatly, and any risks may then outweigh the benefits. Here are some of the most important examples of medical conditions that you should know about:

1. Stroke

Treatment window: 3 hours

For every minute that goes by after a person suffers an ischemic stroke (the kind caused by a blood clot) without medical intervention, 2 million brain cells are lost. And that can mean devastating conse­quences, such as permanent paralysis or the loss of the ability to speak.

A drug called tissue plasminogen activator (tPA) can speedily dissolve the blood clot. But it needs to be administered within 3 hours (or 4.5 hours for some patients) in order to do any good. After that, its side effects—such as bleeding in the brain—far outweigh its benefits. If you or a family member experiences the symptoms of a stroke—sudden on­set of slurred speech, loss of balance, or weakness or numbness of the face, an arm, or a leg—call 911 immediately.

2. Deep cut, puncture wound, or animal bite

Treatment window: 72 hours

Tetanus infection can cause painful contractions of the jaw (lockjaw), neck, abdominal, and chest muscles, and is fatal in about one of every 10 cases. Tetanus bacteria survive in dirt and manure and can enter the body through breaks in the skin. Everyone should have a tetanus booster every 10 years.

But if you’ve had fewer than three tetanus vaccinations over your lifetime and get a deep cut or puncture wound from anything that may be dirty, including animal bites, a shot of tetanus immune globulin (TIG) along with a standard booster will produce protective antibodies if given within 72 hours. After that, it may be too late to prevent a potentially lethal infection from setting in, so go to the emergency room promptly.  

3. The flu

Treatment window: 48 hours

Influenza symptoms, which usually come on suddenly, include intense aches and pains in joints and muscles, fever, chills, cough, sore throat, headaches, and severe fatigue, and usually last four to seven days.

Taking the antiviral agents Tamiflu (oseltamivir) or Relenza (zanamivir) within 24 to 48 hours of onset of those symptoms may decrease their duration by one to three days. (It’s possible that some flu strains can become resistant to Tamiflu.) Seek professional help at the first sign of symptoms.

4. Bell’s palsy

Treatment window: 72 hours

Bell’s palsy is a sudden facial paralysis caused by inflammation of a facial nerve. Though the cause is usually not clear (but Lyme disease and shingles have been implicated in some cases), the results are all too apparent: facial paralysis (usually one-sided), drooping of the eyelid and/or corner of the mouth, drooling, taste impairment, and excessive tearing.

Most people eventually recover, but some may experience long-term disfigurement. Taking oral steroids within 72 hours of symptom onset can reduce the inflammation and is highly effective in restoring function of the affected nerve. If you experience symptoms, go to the nearest urgent-care center or emergency room.

5. Sudden deafness

Treatment window: 72 hours

Sudden deafness usually occurs in just one ear and can be accompanied by ringing and sometimes vertigo. Some research shows that treatment with steroids, vasodilators, and antiviral medications can lead to complete recovery in three out of four cases if it’s started within the first three days.

Generally, treatment can still be beneficial when started within the first week or two but is not helpful after 30 days. Otolaryngologists’ offices and emergency rooms should be equipped to administer treatment.

Orly Avitzur, M.D.

Medical Adviser
Editor's Note:

This article also appeared in the July 2014 issue of Consumer Reports on Health.



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