Facing the challenges of trauma patients

  • Posted on 17.08.2016

Facing the challenges of trauma patients


Prof. Matej Kastelec

Head of the Paediatric Trauma Unit at the University Medical Centre in Ljubljana


What is your day-to-day work like? How do you help improve or save people’s lives through your work?

I work in Ljubljana University Medical Centre, Ljubljana, Slovenia and I’m head of the Paediatric Trauma Unit. I studied and received my medicine degree in the same city, in Ljubljana University. I’ve specialised in orthopaedic trauma for 16 years.

Caring for an injured child requires special knowledge, precise management and great attention-to-detail. An injured child has unique needs and a multidisciplinary approach is needed to deal with the emotional as well as the medical needs of the child.

But the majority of my work involves adult trauma patients and my focus in particular is on elbow, hand and wrist trauma and reconstructions.

It’s a busy, challenging role with complicated procedures, especially when it’s a poly-trauma patient with severe and multiple injuries.  

Every injury creates a different amount of stress: physical and psychological.

If there is a severe injury to a part of the body or to multiple parts, the patient’s health status is not the same as it was before.

My job as a trauma surgeon is to improve and to regenerate the function of the injured part of the body as close as possible to what it was previously. So with different treatment modalities I strive to improve the patients live. This can be done diversely : with non-operative or a surgical treatment, depending on the type of injury. 

What do you think are the challenges facing the healthcare system and your profession in particular?

The line of work we carry out is very complex and demanding. Having a team that can take into account the specificities of the injured patient is key, as well as supporting the family who are facing considerable emotional turmoil and worry.  A high-level of education and continuous medical education for practicing healthcare professionals in this field is vital.

Waiting lists for elective surgery are very long for patients needing surgical attention. Of course, with emergencies we need to act quickly but for those patients on the elective surgery, the waiting period is far too long, with some patients waiting in pain for a year or more for an operation. This needs to be addressed.

Addressing inequalities to patient treatment and care is vital. Having the latest sophisticated, innovative tools is important but not always possible for every hospital and for every patient. Medical attention and quality service should be available for everyone, including those on low incomes.

What role do you see for medical technologies to address these challenges?

When I started in medicine caring for patients, the technology available was generally basic. There has since been a significant improvement due to technological advancement and innovation. Tools for implantation and surgical instruments have been enhanced considerably, helping to treat patients with injuries and improve their outcomes. Ensuring patients have access to such medicines is important.

If you had one ask to the industry, what would it be?

I recognise that medical technology manufacturers need to run a business and succeed commercially. But it would be ideal if industry could help to improve the medical service in poorer countries and ensure patients there are supported. Industry could also support the education and training of healthcare workers. Having travelled across the world for lectures and conferences, I see a significant difference in standards of healthcare practice and this needs to be addressed.

If you had one ask to the decision-makers, what would it be?

Prioritising the challenges outlined, balancing the budget and ensuring a sustainable healthcare system whilst addressing inequalities, patient-centred treatment and the latest innovations is needed.

What would you want to see/is your vision for the care of your patients in the future and healthcare overall?

We are doing well here at the moment in terms of budget and prioritising people’s health; we provide the best of care in surgical implants and the quality of surgical knowledge and skills are very good. However, the politicians in power change regularly and the next round of politicians could change the dynamics and priorities.

The changing demographics and the increase in the elderly and thus frailty is a concern. I would like to see that older people can live more independently and recover well after hip fractures despite their age. I also think older people should have better access to nursing homes rather than staying in hospital far longer than is needed.

I would also like to see that the rehabilitation needs of poly-trauma patients are addressed appropriately. Ensuring such rehabilitation support is provided is crucial as such patients are at risk of additional complications which could have a major impact on their recovery.

Finally, my vision is that healthcare should be about patients, not profit and that all those working with patients need to be reminded that these are people and can be very vulnerable. Amongst my colleagues in surgery, I hope they will see the procedures they carry out as being more than ‘mechanical’ but rather as transforming a patient’s life. Being more humane and taking a genuine interest in the patient you are treating is very important.

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