THE GOLDEN HOUR IN SEVERE TRAUMA: MULTIPROFESSIONAL CARE AND EVIDENCE FOR REDUCING MORBIDITY AND MORTALITY

Abstract

Objective: to synthesize the best scientific evidence on multiprofessional team performance during the golden hour in the care of severe trauma, highlighting strategies that reduce morbidity and mortality and improve clinical outcomes. Method: integrative review conducted according to Whittemore and Knafl and reported following PRISMA 2020, with searches in PubMed/MEDLINE, Embase, Scopus, Web of Science, LILACS, SciELO and the Virtual Health Library, covering publications from 2020 to 2026, with seminal earlier trials still embedded in current guidelines also admitted. Controlled descriptors (DeCS/MeSH) combined with Boolean operators were used. Level of evidence was assessed according to Melnyk and Fineout-Overholt. Results: 22 studies were included. Evidence converges on the effect of coordinated team action nurses, physicians, nursing technicians, pharmacists, radiologists, physiotherapists, nutritionists and psychologists, on process and outcome indicators. Time to hemorrhage control emerged as a critical determinant of mortality; tranexamic acid given within three hours reduced bleeding-related mortality; balanced blood-component resuscitation accelerated hemostasis; and simulation training and structured communication improved team performance and shortened care times. Final considerations: rather than rigid adherence to a 60-minute threshold, contemporary evidence supports that the multiprofessional organization of care, anchored in early hemorrhage control, protocols and team training, is the modifiable determinant of survival in severe trauma, with direct implications for practice, management and public emergency-care policies.