RAH’s innovative, nurse-led approach to address major blood loss

Blood loss is a major challenge after traumatic accidents and for some surgery patients.

As managers within the Royal Adelaide Hospital (RAH) Anaesthetic Nursing Team, Therese and Daryl have established a team of specifically trained nurses that provides a safe and effective solution for patients experiencing significant blood loss.

The approach is called Intraoperative Cell Salvage, or ICS.

“ICS is a process that involves using a cell salvage machine to collect patient’s lost blood during elective and emergency surgery,” says Therese.


“We treat and filter the blood to remove contaminants, and then return red blood cells to the patient.”

The returned cells restore blood volume and oxygen-carrying capacity, facilitating patient recovery.


Benefits for patients

More than 500 patients at the RAH have safely recovered from major blood loss thanks to ICS.

“Research data shows ICS patients experience improved recovery times, lowered length of stay in hospital, and minimised transfusion-related risks such as infection,” Daryl says.


“In addition, availability of ICS means blood bank products can be saved for other patients”.


“ICS also provides a safe and acceptable option for patients who would otherwise refuse traditional transfusion on cultural or religious ground. Staff involved have training to collect and transfuse blood for these patients.”


ICS Team members and others trained in the procedure are able to advocate on behalf of patients if required during surgery or emergencies.


Nurse-led healthcare

Therese and Daryl led a team approach to ensure high quality delivery of ICS for patients at the RAH.

This included formation of a multidisciplinary ICS committee, design of a comprehensive education and training program to empower and upskill nursing staff and increasing the numbers of trained healthcare staff available to assist.

Most RAH patients benefitting from ICS have undergone cardiothoracic, orthopaedic, vascular and emergency trauma surgery.

For surgery where significant bleeding is likely, surgeons are now able to request access to the ICS in advance. ICS can also be provided at short notice, with staff trained and ready.

Recently, staff from The Queen Elizabeth Hospital (TQEH) were trained in a combined approach to increase patient access to the service.