Politrauma, Challenges in Management

Abstract

Introduction: The University Hospital of Trauma, Tirana, Albania, stands as the sole National referral centre for trauma in Albania, a role of immense significance. The primary care centre for trauma often operates beyond its capacity for trauma patients, limiting access to Emergency surgical care for non-trauma patients. For non-traumatic surgical emergencies, there are instructions to inform the patient about the selection for transfer to another institution, such as the University Hospital Centre “Mother Theresa” in Tirana, Albania. Such decisions can be tough for severely ill patients when the transfer benefits are uncertain.
Materials and Methods: To highlight the role of surgeons at different hospital levels, we conducted a qualitative analysis of cases transferred from regional or municipal hospitals to the University Hospital of Trauma.
Results: Surgeons in regional or municipal hospitals face significant challenges. They require transfer when the ability to care for traumatized patients is limited by a lack of necessary staff or equipment, or when the needs for surgical treatment of patients or comorbid conditions are not available locally. Surgeons (non-primary centres) sometimes transfer patients who can be selected at home (Second or third-level hospitals ...) or with fatal safety progress, to try all treatment options or to satisfy families by thus reducing the possibility of benefiting from the treatment of other patients.
Conclusion: The decisions regarding the transfer of surgical patients are not straightforward. They are complex and require a thorough understanding of traumatized patient assessment protocols, knowledge, and capacity coordination, both local and central, as well as in logistics, personnel, and scientific and professional levels. These decisions are not to be taken lightly, and the implications of each transfer must be carefully considered.