Redefining trauma care for the most vulnerable

Published on 3 October 2024

The National University Centre for Trauma focuses on both physical and emotional recovery, particularly for children, older adults and migrant workers.

For 18-year-old Marius Madsen, life changed dramatically when a serious accident at age 14 left him paralysed from the waist down. The care he received at the National University Hospital (NUH) was critical to his recovery.

“The nurses were my daily heroes,” Marius said. “They took care of me around the clock, managing my pain, helping with medications and providing emotional support.”

After a 10-month hospital stay and a gruelling rehabilitation process, Marius regained his strength and flexibility with the help of “amazing” doctors who gave him the confidence that he was in good hands. Physical therapy was “exhausting and frustrating”, Marius recounted, “but the physiotherapists were awesome and kept me motivated.”

Addressing the emotional trauma arising from the accident was just as important as his physical recovery. Besides talking to a counsellor, being part of a trauma survivor support group at the new National University Centre for Trauma helped Marius cope with the emotional aspects of recovery. “It’s a place where I can talk about what I’ve been through and listen to others who get it,” he said. “It makes me feel less alone.”

Four years after his devastating injury, Marius is now giving back by helping others. “Listening to others and offering support makes the group feel like a real community,” he said. “It’s a two-way street where we all help each other heal and grow.”

Today, Marius is pursuing his passion for sports once again. At 14, he had earned a first dan in taekwondo, and after his rehabilitation, he regained control of his thigh muscles, though he still uses a wheelchair. With encouragement from loved ones and the trauma team at NUH, Marius has returned to taekwondo and recently won gold in his first world-ranked Para Taekwondo event at the G2 President’s Cup and the Australian Open 2024 in Brisbane.

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Marius Madsen receiving gold at the Brisbane taekwondo tournament. (Photo: Marius Madsen)

He has also taken up a new sport, archery and is now training with the Singapore Disability Sports Council’s developmental programme and aspires to represent Singapore in the Asean Para Games.

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Aspiring para-archer Marius Madsen trains as part of his journey to represent Singapore in the Asean Para Games. (Photo: Marius Madsen)

“The first time I picked up my bow, it was amazing,” he said. “My proudest achievement is hitting my first bullseye. That moment made all the hard work and perseverance worth it.” He continues to raise funds for training and competitions, and aims to compete in more world-ranking tournaments to qualify for the Para Games.

Decades of efforts come to fruition

Marius’s recovery is just one example of the life-changing impact of NUH’s trauma care services. To provide patients with a larger spectrum of trauma services and focusing on both physical and emotional recovery, the National University Centre for Trauma was launched in July this year. It has a particular focus on three groups – children, older adults and migrant workers – who are especially susceptible to trauma incidents due to their unique vulnerabilities.

“The National University Centre for Trauma represents decades of efforts in refining our trauma care expertise, for our injured patients to return to their lives and achieve their dreams,” said Adj Asst Prof Raj Menon, Centre Director, National University Centre for Trauma, and Senior Consultant, Trauma Surgery Service, Department of Surgery, NUH.

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Marius Madsen, alongside Adj Asst Prof Raj Menon (left) and Dr Lynette Loo, Senior Consultant, Trauma Surgery Service, Department of Surgery, National University Hospital – the doctors who helped him recover.

Each year, NUH attends to an average of 1,300 severe and critical trauma cases. These include 140 industrial accidents and 70 paediatric trauma incidents, making it one of Singapore’s largest trauma centres for such emergencies, and the only tertiary hospital looking after both adults and children.

Expediting care at the National University Centre for Trauma

● Code Trauma: A hyperacute response code system that has halved the time needed to transfer a patient from the emergency department to the operating theatre. This system mobilises essential personnel – such as emergency physicians, nurses and trauma surgeons – to quickly respond and manage severe trauma cases, including bleeding in patients with polytrauma or multiple injuries.

● Multi-disciplinary trauma clinic: A one-stop centre offering combined consultations and therapy for recovering trauma patients. This reduces the need for multiple visits to different healthcare professionals. Through weekly patient-centred meetings, it also enhances rehabilitation, psychosocial recovery and care coordination.

Support and recovery are possible

Another inspiring example is Madam Lim, a 51-year-old who has benefitted from NUHS’s commitment to holistic trauma care. After a motorcycle accident last July left her with fractured ribs and pelvis, Madam Lim faced a long process of recovery. She only realised the full extent of her injuries when she tried to get out of bed in the hospital – and experienced excruciating pain.

Through regular physiotherapy, Madam Lim has since regained full mobility and resumed her job as a customer service professional.

Beyond her physical recovery, the trauma survivor support group at the National University Centre for Trauma has brought her much-needed emotional comfort. “We do activities together like art therapy, and also share about what happened to us,” she said.

When a fellow patient started to open up to her after a few sessions, Madam Lim recalled feeling comforted and encouraged. “For some of us, it is not easy to talk to our family about the trauma because they may not fully understand what we are going through.”

Reaching out to vulnerable groups and supporting survivors

● Community and school outreach: The National University Centre for Trauma works with community partners and schools to raise public awareness about injury prevention. Workshops have been conducted with pre-schools, primary schools and active ageing centres, such as the Queenstown Mei Ling Zone Resident’s Network, to promote safety awareness among children and older adults. More workshops are planned for primary schools and community centres.

● Trauma survivor support group: Launched by the National University Centre for Trauma last year with 10 members, Singapore’s first trauma survivor support group provides resources and a sense of community for patients to address the psychological effects of trauma. The group plans to reach more individuals to help them cope with trauma, which can linger long after the physical wounds have healed.

In consultation with Adj Asst Prof Raj Menon, Centre Director, National University Centre for Trauma, and Senior Consultant, Trauma Surgery Service, Department of Surgery, NUH.