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Cell Salvage

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Cell salvage is a method of collecting blood that you may lose during an operation. The blood collected is filtered and washed to remove contaminants. If needed, it can be given back to you through a small tube into a vein. Your blood will only ever be given to you and cannot be used for someone else.

Cell salvage is a technique that is well established in many types of surgery and is used regularly at Southmead Hospital.

Why might I need a blood transfusion?

It is normal when having a caesarean section, to lose some blood during the procedure. Most of the time, the blood lost can be replaced with other fluids. Your body will make new red blood cells over the next few weeks.

However, it may be necessary to replace the blood by giving a blood transfusion. Blood used for these transfusions can be:

  • A supply of donor blood from volunteers
  • Your own blood using the cell salvage method
  • Both donor blood and your own blood

What are the benefits of cell salvage?

The use of cell salvage can reduce the need for a blood transfusion of donor blood.

Although risks associated with receiving a blood transfusion from a donor are low, there are still very small risks of infection being passed on. Having your own blood returned to you removes these risks and may decrease your length of hospital stay.

Donor blood is stored before transfusion and this can affects its properties: for instance, stored blood does not carry oxygen as well. Having your own blood returned to you straight away eliminates these problems.

The cell salvage technique is sometimes seen as an acceptable alternative for those who will not accept a transfusion using donated blood as cell salvage is a continuous circuit.

What are the risks of cell salvage and how can they be prevented?

1. Amniotic Fluid Embolism

There is a theoretical risk that the fluid that surrounds the baby, amniotic fluid, could be returned to the mother. This could potentially cause a condition called amniotic fluid embolism that can cause harm through an allergic reaction.

However, the washing and filtering mechanisms of the machine are very effective in removing amniotic fluid. Cell salvage has been used in caesarean section for many years and there is no evidence of this happening.

2. Antibody formation

There is a risk that the baby’s blood can get into your bloodstream. This may cause antibodies to develop that can harm the baby in future pregnancies. The most common blood group where this happens is if you are RhD negative and your baby is RhD positive.

There is always risk of mixing mother and baby’s blood during a caesarean section or delivery, even when cell salvage is not used. Therefore, to prevent antibodies forming, all mothers who have Rhesus negative blood group have a blood test after the operation. A drug called Anti-D Immunoglobulin is given to mothers whose baby has Rhesus positive blood group to prevent problems in future pregnancies. This is given irrespective of whether cell salvage has been used and can be given up to 72 hours after the operation.

What does this mean for you?

This information will help you make an informed decision on receiving your own blood back (cell salvage) during surgery. If you have any questions about cell salvage, which are not answered by the leaflet, please discuss them with your Anaesthetist.

Further information

For further information about cell salvage visit: www.transfusionguidelines.org

The use of cell salvage in caesarean sections has been endorsed by: 

  • National Institute for Health and Clinical Excellence (NICE)
  • Confidential Enquiry into Maternal and Child Health (CEMACH)
  • Obstetric Anaesthetists Association (OAA)
  • Association of Anaesthetists of Great Britain and Ireland (AAGBI)

Pain Management Who we are

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Pain Management Who we are 

Pain has an impact on many areas of life including how you move, what you do, your finances, your mood and sleep, your relationships, and your thought processes. 

These areas of life also have an impact on how people manage their pain. This is why the pain management service has different specialists working together to look at the impact of your pain. 

Psychologists

Pain can have a significant effect on the way you think, feel, connect to others, and sleep. It can affect your self-esteem and confidence, and make you feel stuck.

Some patients worry that psychologists might think pain is “all in the mind.” We know that your pain is real, the longer pain goes on, the more areas of your life it can affect. 

Our priority as psychologists is to help you:

  • Understand the impact of your pain.
  • Make meaningful changes to manage pain.
  • Improve your quality of life.

Psychologists

  • Hazel O’Dowd (Head of Department)
  • Julia Cordey
  • Kelly Paull
  • Lindsey Hume
  • Nicholas Ambler
  • Oonagh Koppel
  • Sebastian Eisenberg
  • Vicky Williams

Physiotherapists

We specialise in supporting people with long term, persistent pain. We may work differently to physiotherapists you have worked with before. Pain can make it harder to move, and over time this may make the pain worse. 

As pain management physiotherapists, we focus on the whole person looking at ways to improvement and activity based on your goals. By helping people get stronger and manage their symptoms, this can help lower stress and give you more control of your life.

Physiotherapists

  • Crispin Barker
  • Hazel Stevens
  • Irene Campagnolo Maschio
  • Melanie Berry 

Occupational therapists

Occupational therapy helps you do the things you need and want to, at home or anywhere else. 
An occupation is any activity you do to take care of yourself like washing or eating, to be productive like working or studying, or fun like hobbies and socialising. Occupations give life purpose and connect us to others.
When pain makes it hard to do these things, occupational therapy can help you adjust to have the best quality of life.  

Occupational therapists

  • Caroline King
  • Leanne Nabosi

Patient volunteers

We are lucky to have help from past patients who know what it is like to live with pain. They help in many ways:

  • Volunteers help run our self-management programmes with one of the team. They also give advice and support to new patients, and share their experiences.
  • Volunteers join meetings to help plan our future services, review our paperwork, and help with how we run our groups. 

© North Bristol NHS Trust. This edition published May 2025. Review due May 2028. NBT003600.

Dr Andrew Bamber - Pathology

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GMC Number: 7016946

Year of first qualification: 2008, University of Cambridge

Speciality: Paediatric & Perinatal Pathology

Clinical interests: Paediatric autopsy pathology, Perinatal autopsy

pathology, Placental pathology, Cardiac pathology, Adult autopsy pathology

Secretary: Perinatal Pathology Secretaries

Telephone: 0117 414 9890

Dr Bamber works as a Consultant in Paediatric and Perinatal Pathology and is
based at Southmead Hospital and in the mortuary at St Michael's Hospital,
Bristol.

His routine practice includes general paediatric surgical pathology
(including non-CNS tumours), placental pathology, perinatal pathology, and
paediatric/adolescent autopsy. His main specialist interests relate to
autopsy pathology and he is an experienced adult, paediatric and perinatal
autopsy pathologist.

Dr Bamber is a member of the British Association in Forensic Medicine, the
Pathological Society of Great Britain and Ireland, the European Society of
Pathology, The British and Irish Paediatric Pathology Association, and the
Paediatric Pathology Society.

 

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Bamber

Identifying & Supporting Children's Early Language

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Public Health England (PHE) has commissioned Speech and Language Sciences at the University of Newcastle to develop and evaluate a new process for early identification of children at risk of developing speech and language disorders, in collaboration with Bristol Speech and Language Therapy Research Unit and the Institute of Health Visiting.

Why is this important?

Speech and language are critical to children’s development, and speech, language and communication needs (SLCN) can affect their educational attainment, social and emotional development and opportunities later in life. It is therefore essential that children with SLCN are identified early to ensure they receive the right support and reduce the risk of problems in the long term.

However, the Bercow 10 Years On Report published in 2018 found that “more than half of young children in school are not having their needs identified, often due to insufficient knowledge and skills in the workforce” (p30). The report also showed that the screening tools which are currently used do not feature important ‘red flags’, which could provide early signs of SLCN.

How will the project work?

PHE have developed a programme to improve identification of SLCN, including training health visitors, providing better guidance to local authorities and provision of an early assessment tool. The University of Newcastle has been selected to create this tool, led by Professor James Law in collaboration with Dr. Cristina McKean.

The new screening tool will be conducted alongside the Ages and Stages Questionnaire (ASQ), which is commonly employed by health visitors and early years practitioners at children’s 2-year developmental checks. The screening tool will be tested and evaluated by health visiting teams in five areas around England, working with a total of 1280 preschool children. The project will also develop resources to foster understanding of SLCN among health visiting teams and parents, and to help them to support children with their speech and language.

How are BSLTRU involved?

There are four strands to the project:
1)      Development of the early assessment tool
2)      Public and Patient Involvement (PPI) Groups
3)      Evaluation and Feedback
4)      Co-Design

The team at BSLTRU, led by Professor Sue Roulstone in collaboration with Caitlin Holme, are responsible for evaluation and feedback. They will gather parent and professional perspectives of the new process and contribute this insight to the development of the tool, with the objective of ensuring acceptability for those who will be using and receiving the assessment in future.

Evaluation of the parent and professional perspective will comprise a parent survey, completed by all parents whose children have been assessed via the new process, as well as telephone interviews with parents and focus groups with health visitors and speech and language therapy teams.

BSLTRU are also involved in running the PPI groups and co-design elements of the project, which aim to include parents and professionals in the design of the assessment tool and further resources.

How can I find out more?
If you are interested in learning more about the project please visit the project website here: https://research.ncl.ac.uk/slcn/, or email caitlin.holme@nbt.nhs.uk for more information.

Dr Scott Grier - Anaesthetics

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GMC Number: 6163881

Year of first qualification: 2007, Imperial College, London

Speciality: Intensive Care Medicine & Anaesthesia

Clinical interests: Inter- and intra-hospital transfer of critically ill patients, pre-hospital critical care

Secretary: Anaesthetic secretaries

Telephone: 0117 414 2641

Dr Scott Grier (MBBS, BSc, FRCA, FFICM, FIMC RCSEd) is a consultant in Intensive Care Medicine and Anaesthesia.

He has a strong interest in the inter- and intra-hospital transfer of critically ill patients and is Co-Chair of the South West Critical Care Network Transfer Group. In addition, he is a Critical Care Doctor for Great Western Air Ambulance and SWIFT Medics.

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Grier

Mr Mario Teo - Neurosurgery

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GMC: 6079773

Year of first qualification: 2003, University of Sheffield

Speciality: Neurosurgery

Clinical interests: Cranial and spinal microsurgery, Minimally invasive keyhole & endoscopic surgery Complex brain tumours Cerebrovascular neurosurgery Neurocutaneous disorders (Neurofibromatosis)

Secretary: Nikki Jesson / Sheila Birch

Mario Teo is a Consultant Neurosurgeon and Honorary Senior Clinical Lecturer at Bristol Institute of Clinical Neuroscience, North Bristol University Hospital, having completed a Cerebrovascular and Skull Base fellowship at Stanford University, California, USA. He qualified in medicine from the University of Sheffield, also gaining an intercalated research honours
degree- BMedSci. He then trained in Neurosurgery at Glasgow, Cambridge and London. He has a special interest in minimally invasive cranial and spine surgery, is a firm believer in personalized health care, surgery with less tissue injury, leading to minimal scar and quicker recovery.

His clinical focus includes management of complex brain tumours (schwannoma, meningioma, craniopharyngioma, skull base tumours, neurocutaneous disorders) and cerebrovascular pathologies (moyamoya disease, cerebral aneurysm, arteriovenous malformation, cavernoma, haemangioblastoma), incorporating various surgical techniques (keyhole surgery, endoscopic endonasal approaches, cerebral revascularizations) and technological advancement (3D reconstruction, fibre tracking, virtual reality, intraoperative neuromonitoring).

Academically, he has authored numerous peer-reviewed publications, editorials, book chapters, and is also an advocate of collaborative clinical and scientific research, at local, national and international level.

Professional memberships
World Federation of Neurosurgical Societies (WFNS) European Association of Neurosurgical Societies (EANS) Society of British Neurological Surgeons (SBNS) American Association of Neurological Surgeons (AANS) Congress of Neurological Surgeons (CNS) British Neurovascular Group (BNVG) British Skull Base Society (BSBS) British Medical Association (BMA)
 

www.iwantgreatcare.org/doctors/mr-mario-teo

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Teo

Dr Edward Walton - Radiology

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GMC: 7042109

Speciality: Radiology

Clinical interests: Musculoskeletal Radiology

Secretary: Gail Bailey

Telephone: 0117 414 9008

Dr Walton has completed post CCT musculoskeletal radiology fellowships in the UK and Australia with expertise in all facets of musculoskeletal diagnostic imaging and image guided intervention.

Dr Walton is a fellow of the Royal College of Radiologists and a member of the British and European Societies of Skeletal Radiology.

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Walton
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