Want to have your say? Listening to you, helps us too

Taking part in research doesn’t necessarily mean being treated as part of a study.

At NBT we have a variety of groups involving members of the public who help us to review and  improve the care we give to our patients.

Your involvement helps to ensure that our focus remains on what is most important – the people we look after. We believe that people with personal experience of healthcare are best placed to comment on what research is needed and how research should be done.

You don't need any research experience to join, just fresh perspectives that can guide our researchers, helping to make our research more relevant and acceptable to the people who use our services.

You will be able to:

• Comment on the researcher’s treatment ideas.
• Discuss how the treatment will be carried out.
• Read and give feedback on patient information sheets, letters to patients and patient questionnaires.
• Keep updated on how the research study is progressing.

You can be involved as much or as little as you wish, depending on your personal circumstances. Each group is different, with some meeting for approximately 2 hours every 8 weeks, and others meeting just once or twice in total.

Please see the some of our Current Opportunities below. 

If you are interested in a particular health condition that is not listed below, please do get in touch by emailing researchcommunications@nbt.nhs.uk

Women & Children's groups

What is Bell’s palsy?

Bell’s palsy is a medical problem causing weakness of the muscles on one side of the face. It is usually temporary - with most people making a full recovery within two to three months. It comes on suddenly and the cause is unknown.

The facial nerve supplies the muscles in your face. In Bell’s palsy this nerve is affected, leading to weakness or paralysis of the muscles that control smiling, frowning, eating and closing the eyelids. It can also affect your ability to taste.

Bell’s palsy can affect men and women of any age but is most common in 15-45 year olds. In the UK it affects approximately one in 70 people at some point in their lifetime.

What are the symptoms of Bell’s palsy?

The symptoms of Bell’s palsy often occur very quickly, over a few hours or overnight. The weakness or paralysis usually affects one side of your face.

The symptoms will vary and may include:

• Facial pain around your ear on the affected side
• Drooping of the face on one side
• When you smile, only one side of the face may move, you may not be able to frown and speaking clearly may be difficult
• Difficulty closing your eye. It may not fully close and may water or become dry
• Difficulty when chewing food, you may dribble slightly
• Altered or loss of taste on one side of your tongue
• Sensitivity to noise. Noises may sound louder than usual which can be uncomfortable.

Treatment

Medications

You may have been prescribed oral steroids (prednisolone) if your symptoms started in the last 3 days. If you have been prescribed steroids take 50mg (10 tablets) once a day for 10 days along with omeprazole 20mg once a day for 14 days then stop. Steroids may help to reduce inflammation and decrease the likelihood of damage to the facial nerve.

Mouth care

As the facial muscle may not be functioning fully, food may become lodged around the teeth and gums on the affected side. Make sure you remember to clean this area well and remove all debris after eating.

Eye care

Eye care is very important if your eye is affected. If your eye does not close when blinking:

• The eye can dry up. You should use eye drops or artificial tears to keep the eye moist. Use artificial tear drops during the day and a thicker solution at night. Ask your pharmacist for advice.
• The eye will not have the normal protection from the eye lid closing. It is important to protect the eye and avoid scratching the cornea (the thin, transparent layer covering the eye). Do not use contact lenses until your eye returns to normal. You may be advised to wear an eye patch by day and to tape the affected eye lid closed at night if your eye does not close when you sleep. Tape such as transpore can be used for this.

Advice for taping of the eye shut at night

1. Cut the tape slightly longer than the width of your eye.
2. If using night time ointments these should be inserted into the eye.
3. Look down.
4. Assist the eye closure with the back of your finger.
5. Apply tape from the inner corner to outer corner of the eye in a horizontal direction so that it extends beyond the width of the eyebrow.
6. Ensure that the eyelid is fully closed; the tape is on the upper lid and covers the area underneath the eye.

Video: www.facialpalsy.org.uk/support/patient-guides/how-to-tape-eye-closed-adults/

Exercises can be useful to tone the facial muscles as the movement begins to return, perform 10 each of these exercises 4 times a day:

• Gently raise your eyebrows – you can help the movement with your fingers
• Wrinkle your nose
• Try and flare your nostrils
• Lift one corner of the mouth and then the other
• Smile without showing your teeth, then smile with showing your teeth
• Bring your eyebrows together in a frown

Prognosis

75 to 90 people in every 100 people who have Bell’s palsy start to improve within three weeks, and make a full recovery within two to three months. However, about five to 10 people in every 100 people who have Bell’s palsy have some slight weakness which remains forever. Rarely there may be little or no improvement.

Do I need follow up?

Most people with Bell’s palsy make a full recovery in 3 weeks to 3 months. If you do not make a full recovery in 3 weeks then make an appointment with your GP.

If you are unable to close your eye normally and develop pain, stinging or visual disturbance please attend the Eye Casualty at the Bristol Eye Hospital in the next 24 hours. The Bristol Eye Hospital Casualty is open 7 days a week from 8.30am - 4.30pm. Further information can be found at www.uhbristol.nhs.uk/patients-and-visitors/your-hospitals/bristol-eye-hospital/how-to-find-us/

© North Bristol NHS Trust. This edition published June 2022. Review due June 2025. NBT003415

If your child has ingested (swallowed) a super strong magnet

If your child has swallowed a button battery

© North Bristol NHS Trust.  This edition published April 2024. Review due April 2027. NBT003414.

Easy Read

VNS stands for Vagal Nerve Stimulator.

It helps treat your epilepsy.

It is a device in your body that send signals to a nerve. It helps calm down your brain activity when you have a seizure.

The battery on your VNS is low. 

You need to come to the hospital to have a new VNS battery.

Before your surgery, you will see the epilepsy nurses to make sure you are healthy and ready for surgery.  

You can't have food or drink before your surgery. 

You can have your normal medications. 

You will arrive at the hospital for your appointment at the time you have been told. 

Your family or carer can support you. 

You will go to Medirooms. It is in the blue zone. 

You will check in at the desk. 

You will wait in the waiting room.

Your name will be called. 

A nurse or healthcare assistant will show you to your room. 

You will wait in your room. This is your room for the rest of the day. 

The nurse will check you in. They will ask you lots of questions to check you are healthy for the surgery. 

The doctors and anaesthetist will see you in your room. 

You will have a cannula fitted to your hand or arm. 

You will be taken to the theatres. 

Your family member or carer can get dressed into scrubs and come with you.

The anaesthetist will give you medicines to help you sleep.

You will have your VNS battery changed.

You will be asleep and won’t feel anything.

You will wake up in your hospital room.

Your family or carer can be there when you wake up.

You might have monitors on your arm when you wake up.

You might still have a cannula in your hand or arm.

You will have a bandage on your chest.

If you feel sore, the nurses can give you medicine to help you.

Your nurse will look after you.

When you have woken up you can have something to eat and drink.

When you are feeling well enough you can go home.

Wear your bandage for one week.

Keep your bandage dry when you shower.

A nurse will take the bandage off.

You will see your epilepsy nurse to check the VNS.

If you have a learning disability or autism and have any questions, you can call the hospital learning disability and autism liaison team on 0117 414 1239.

© North Bristol NHS Trust This edition published December 2022. Review due December 2025. NBT003502 EASY READ

Information for day case patients

You have been diagnosed as having an abscess that needs surgical treatment. We have arranged for you to have your operation as a day case.

This means that you will come back first thing in the morning, have your operation and go home on the same day.

Where do I go?

You need to report to the theatre reception Gate 20, level two. You will be asked to go there at 7.30am.

Preparation for day surgery

• Please make arrangements to leave young children at home with someone. We have no facilities for children.
• If you are having a general anaesthetic you must arrange for a responsible adult to take you home and stay with you for 24 hours. If you are taking a taxi home you must have a responsible adult to go with you.
• Even if you are having a local anaesthetic it is recommended that you have someone to take you home. You must not drive if your mobility is restricted by the surgery or if you have had an anaestheic. Your insurance may not cover you immediately after an operation.
• Please arrive promptly at 7.30am as instructed. Do not eat or drink anything except water from midnight the night before. You may drink water until 6am.
• If you feel worse overnight or need some advice ring 0117 414 3233 or NHS 111.
• Before coming in, remove all make-up and nail varnish.

What should I bring?

• Leave all your valuables and jewellery at home.
• Bring in any tablets, medicines and inhalers that you normally take.
• Bring a dressing gown and slippers. We will give you an operating gown to change into for your operation.
• We suggest you bring a book or something to do while waiting for your surgery. The staff will let you know how long you have to wait. 

Arriving for your operation

• The staff in the theatre mediroom will take down details of how you will get home. We will phone your escort when you are ready to go home.
• The nursing staff will get you ready for your operation and answer any questions you may have.
• The anaesthetist will see you before your operation and explain the anaesthetic. The surgeon will have explained and consented you in SDAU/SAU but if you have any further questions please ask to speak to the surgeon the day.
• Most patients will be put to sleep i.e. have a general anaesthetic for the procedure, but in some cases the abscess may be treated with a local anaesthetic which means the area will be made numb. The doctor who has assessed you will have told you which is most appropriate.
• Your operation will be planned to be first on an operating list reserved for patients with an emergency condition. However, if an urgent operation for a more life-threatening condition is needed, your operation may be delayed. If this happens, we will do our best to perform your operation later in the day.

Immediately after your operation

• You will be taken back to a mediroom where we will treat any pain or sickness that you may experience.
• You will be offered a drink and a biscuit.
• Your can dress in the mediroom.
• You can then sit and wait for your escort to arrive.

Discharge home

We expect that you will go home the same day. If there are complications such as severe pain or sickness, you may have to stay in hospital.

If you do have any problems when you arrive home, contact your GP, district nurse or NHS 111 or for major problems SAU on 0117 414 3233.

Anaesthetic drugs remain in your body for several hours. During this time you will react more slowly and be more likely to have an accident. You may need some days off work and help at home.

We advise that for 24 hours you should not:

• Drive your car or any other vehicle
• Cook or operate machinery
• Drink alcohol or take sleeping tablets
• Make important decisions or sign legal documents

You will need regular painkillers immediately after the operation. If you do not have suitable painkillers at home, you will be given tablets to take home with you. You will be given verbal and written advice about wound care and pain relief.

You will likely require a dressing on the area, often changed regularly for a few days or weeks. You can arrange for your GP practice nurse or district nurse to do this, please take your discharge summary as soon as possible to your surgery to arrange this. If your GP surgery cannot provide the service most NHS walk-in centres will. In most cases, the abscess will heal and you will not be seen again at the hospital.

If follow-up is planned, for specific complicated abscesses, this will be arranged for you by the hospital team and you will receive a letter in the post for the test or clinic.

How to contact us

Major Trauma Team
Surgical Assessment Unit
Gate 32B, Level 1
Brunel Building
Southmead Hospital
BS10 5NB

Telephone: 0117 414 3233

© North Bristol NHS Trust. This edition published July 2022. Review due July 2025. NBT002946

This page is for patients diagnosed as having a rib or chest injury.

Chest injuries are extremely common following blunt and penetrating trauma. They can vary in severity from minor bruising or an isolated rib fracture to severe crush injuries causing multiple fractures and bleeding which result in pain and breathing problems.

Common causes of rib injury include motor vehicle accidents, falls and assaults. Treatment aims to relieve pain allowing you to perform normal tasks while the injury heals.

The majority of chest injuries are treated without requiring an operation, but a chest drain may need to be inserted. Occasionally with severe injuries the ribs may have to be fixed. This requires an operation that is performed under general anaesthetic.

If you follow the advice given to you on this page and by the healthcare professionals on the ward you should find your chest injury much easier to understand and manage.

Types of injury

Your clinician will let you know which injury type you have.

Rib fractures

A rib fracture is a break in a rib bone. Bruising of the surrounding muscles and ligaments often occurs with these rib fractures. The lungs and other organs underneath the ribs may also be injured.

Flail chest

A flail chest occurs when a segment of the rib cage is separated from the surrounding structures. This is usually defined as at least two fractures per rib, in at least two ribs.

Sternal fracture

A sternal fracture is a fracture of the sternum (the breastbone), located in the centre of the chest.

Pneumothorax

A pneumothorax is a collection of air between the lung and chest wall that causes part or all of a lung to collapse.

Haemothorax

A haemothorax is a collection of blood between the lung and chest wall which may be caused by blunt or penetrating injury.

Lung contusion

A lung contusion is bruising or bleeding of the lung tissue that may cause pain and trouble breathing. It is a common lung injury after blunt trauma to the chest wall.

The chest

The ribcage supports the upper body, protects internal organs, including the heart and lungs, and assists with breathing.

Rib injuries include bruises, torn cartilage and bone fractures.

Symptoms of chest trauma

• Pain at the injury site.
• Pain when the ribcage moves. For example with movement, when you take a deep breath or when you cough, sneeze or laugh.
• Breathing difficulties.
• Coughing up blood or discoloured sputum
• Increased temperature
• Pain relief.
• Oxygen therapy.
• Early mobilisation.
• Physiotherapy.
• Chest drain(s).

Very occasionally surgery is required to stabilise the fractures. In severe cases intensive care treatment is also required. If this is needed your doctor will discuss it with you/your family.

Complications

Possible complications of chest trauma include:

• Pain.
• Pneumothorax / Haemothorax (see previous definitions).
• Chest infection – to avoid this it is important to ensure your pain relief is adequate so you are able to take deep breathes, cough and mobilise.

Pain management

• The most important treatment with chest trauma is to have good pain relief.
• Take regular pain relief so you are able to deep breathe, cough and mobilise – these are vital for you to do as they aid your recovery and help prevent complications such a chest infection.
• Inform your nurse and doctors if you feel your pain relief is not adequate.
• Do take the recommended pain relief and/or anti-inflammatory tablets; these will improve your healing time.

Lidocaine plasters for rib fractures

Lidocaine is a local anaesthetic which works by diffusing into the skin, causing numbness and relieving pain at the site of the rib fractures.

You have been given lidocaine plasters to treat pain from rib fractures and to enable you to deep breathe and cough more easily.

Prior to using the plaster any allergies should be discussed with your healthcare professional to ensure this treatment is safe for you.

Between one and three plasters will be used depending on your rib injuries. The plaster/s must be applied to dry skin with no cuts or sores. Any hairs over the affected area may be trimmed with scissors (not shaved). Do not apply cream or lotion to the area as the plaster may not stick. If you have had a recent bath or shower, wait until the skin cools prior to sticking the plaster on. Try not to then get the plaster wet. 

Lidocaine plasters must only be left in place for 12 hours, then they must be removed for a 12 hour break. For example, your plasters may be applied at 9am and removed at 9pm so that you have a break from them overnight.

Lidocaine plasters are used for between three and five days alongside other forms of pain relief. After this rib fracture pain is usually manageable with other oral painkillers.

If you develop skin irritation at the plaster site it will need to be removed and not reapplied unless the irritation settles.

Please speak to your doctor or nurse if you have any questions about this form of pain relief.

Local Anaesthetic Nerve Blocks (Epidural, Paravertebral or “Fascial Plane” Blocks)

These provide effective pain relief through an injection of local anaesthetic to help numb the injured area. A very small, sterile plastic tube may be inserted to infuse local anaesthetic and help reduce your pain for several days. Anaesthetists perform these blocks and will explain everything to you including any risks.

Chest drains

If you have a pneumothorax or haemothorax you may need to have a chest drain inserted. If this is required your doctor will discuss it with you and explain the procedure.

A chest drain is a sterile soft plastic tube that is inserted into the space between the lung and the chest wall. It is used to drain air (pneumothorax) or blood (haemothorax).

If you have a chest drain some important things to know are:

• You may see air bubbling out through the drainage bottle or fluid draining. This is expected and will be monitored.
• You must keep the drainage bottle below the point the drain enters your chest. Usually it is placed on the floor. It is also essential that the bottle is kept upright.
• The drain can come out if pulled or twisted so try to be careful when moving. If the drain does come out tell someone straight away.
• The drain may cause discomfort, but is unusual to cause significant pain. If it is painful do inform your nurse and ask for painkillers.

Physiotherapy and breathing exercises

Breathing exercises

Start in a comfortable position, ideally sitting upright in the bed or chair with your shoulders relaxed.

• Take a long, slow, deep breath in, as much as possible.
• Hold this breath for three seconds.
• Slowly breathe out.
• Take three more deep breaths in the same way.
• Return to breathing normally.
• Try to repeat hourly.

Coughing

The breathing exercise should be followed by a cough. It is very important to cough effectively after a chest injury so that you can clear any sputum promptly and help prevent a chest infection.

Discomfort may be reduced by using a folded towel or pillow to support your chest while coughing.

If you feel that you are unable to clear your chest effectively or are concerned about an excessive amount of sputum, please inform your nurse who will refer you to the respiratory physiotherapist.

Repeat the breathing exercises and coughing at regular intervals for the first few days following your injury.

They may be discontinued when you are walking independently and your chest is clear. 

Early mobilisation

You will be assisted by the nursing staff or physiotherapist to mobilise as soon as possible after your injury. It is essential your pain relief is adequate to enable you to do this.

What to do once you are discharged from hospital?

It’s very important to continue to take regular pain relief as prescribed.

Once you have been discharged from hospital make an appointment to see your GP within three days.

Your GP may order a follow up chest x-ray and monitor your broken rib(s).

You need to tell your GP:

• If you are feeling more unwell since going home.
• If you develop a fever.
• If your pain medication is not working.
• If you are not able to deep breathe or cough.
• If you are a smoker.
• If you are constipated from pain medication.

Take your hospital discharge summary with you. This summary tells the GP what has happened, tests done and what should happen with your care.

You should seek medical advice immediately from either your GP or emergency department if you have any of the following symptoms after discharge:

• Sudden onset of chest pain.
• Difficulty breathing.
• Shortness of breath.
• Uncontrolled pain.

How to contact us

Major Trauma Team

Gate 19, Level 2

Brunel Building

Southmead Hospital

Bristol

BS10 5NB

Telephone: 0117 414 1546

Email: MajorTrauma@nbt.nhs.uk

© North Bristol NHS Trust. This edition published July 2022. Review due July 2025. NBT002945

What is gastroenteritis?

Gastroenteritis is an infection in the gut which causes diarrhoea and/or vomiting. It can also cause tummy pain and a raised temperature. It is usually caused by a virus, and most children are able to recover at home with simple treatment. The diarrhoea and vomiting can lead to dehydration, when too much water is lost from the body.

How long does it last?

Gastroenteritis can cause symptoms which last up to 2 weeks, but most cases last for a much shorter time.

What can I do to help?

If your child has a temperature or tummy pain then give paracetamol according to the instructions on the bottle.

Offer small amounts of fluid to drink frequently. Do not offer a full bottle or cup of fluid at once as a large volume may make your child vomit again.

What kind of drinks should I give?

You can continue the usual drinks your child has including milk, but avoid full strength fruit juice or fizzy drinks.

Oral rehydration solution (e.g. dioralyte) is a salt and sugar solution which comes in sachets which helps to replace what is being lost. This can be used to supplement your child’s normal fluids.

If your child is breast-fed, you should continue to breast–feed. You may need to feed them more often, and some children need additional formula feeds.

If your child is formula-fed you should continue giving full-strength feeds, but small amounts more frequently.

What about food?

Don’t worry if your child doesn’t feel like eating. Offer food that isn’t too fatty or sugary – try crackers, toast or plain biscuits to start with. Their appetite will improve as they start to recover.

When should I ask for more help or advice?

Seek advice if:

• The diarrhoea has blood in it.
• Your child becomes more sleepy, lethargic or irritable than usual.
• Your child seems unable to keep any fluids down.
• Your child has a high temperature.
• Your child has more than 9 loose stools in 24 hours.
• Your child has severe abdominal pain.

You can call your health visitor or General Practitioner.

You can call the 111 advice line.

If you are worried your child is becoming more unwell you should return to the Emergency Department.

When can my child return to school or nursery?

When 48 hours has passed since their last episode of diarrhoea or vomiting then they are safe to return

How can I stop it happening again?

Gastroenteritis is an infection which can be passed on from person to person or in contaminated food. Always wash hands before preparing food or eating, and after nappy changes or going to the toilet.

Children with diarrhoea or vomiting should not share towels with other children and should not swim in a public swimming pool until 2 weeks after recovery.

References

National Institute for Health and Care Excellence (2009); Clinical Guideline 48, Diarrhoea and Vomiting in Children. Available at www.nice.org.uk

Bristol Royal Hospital for Children local guideline on Gastroenteritis

How to contact us

Hospital switchboard: 0117 950 5050

© North Bristol NHS Trust. This edition published December 2022. Review due December 2025. NBT002853

It can be very frightening when a child has a febrile convulsion, but children usually recover well and are able to return home from the Emergency Department. This leaflet aims to answer some common questions about febrile convulsions and gives some practical advice.

What is a febrile convulsion?

A febrile convulsion is a fit (a seizure) which happens when a child has a high temperature.

It usually happens in children aged between 6 months and 6 years old.

About 3 in 100 children have a febrile convulsion.

What does it look like?

A convulsion is caused by increased activity in the brain.

This usually means that the affected person becomes stiff, their arms and legs may jerk, and they become unaware of their surroundings.

They are usually sleepy and confused for a while afterwards.

What should I do if my child has a febrile convulsion?

• Try to stay calm.
• Lie your child on their side on a flat surface, for example the floor.
• Wait for the convulsion to stop.
• DO NOT restrain or shake your child.
• Usually the fit stops within five minutes. Your child may be sleepy afterwards. If the fit has stopped arrange for a doctor to see your child by contacting your GP.

When should I call an ambulance?

Call 999 if:

• The convulsion lasts longer than five minutes.
• Another convulsion starts after the first one stops.
• Your child has difficulty breathing or looks very unwell.

Will my child have another convulsion in the future?

Most children will only ever have one febrile convulsion but a few will have more than one.

After the age of 6 it is very rare for a febrile convulsion to happen.

Very few children who have a febrile convulsion go on to have seizures in later life (epilepsy).

What should I do if my child has a fever?

Do

• Keep your child lightly dressed and give cool drinks.
• Give paracetamol (‘Calpol’) or ibuprofen (‘Nurofen’). These can be bought from the chemist and can help bring a temperature down.

Do not

• Bathe your child in cold water or put them directly in front of a fan.

References

Jones et al, (2007) Childhood febrile seizures overview and implications, I.J.M.S.

Armon K et al, (2003) An evidence and consensus based guideline for the management of a child after a seizure Emergency Medicine Journal.

Contact us

Telephone: 0117 414 5100

© North Bristol NHS Trust.  This edition published July 2022. Review due July 2025. NBT002255

A high fever does not necessarily mean that your child has a serious illness. Fever is a sign of infection which is usually caused by a virus, but occasionally a bacterium. Bacterial infections are usually treated with antibiotics. Antibiotics do not kill viruses. Fever is thought to be a normal reaction by the body as it fights the infection.

Management of fever

Treat fever if you feel that it is making your child uncomfortable and irritable. You can do this by doing the following:

1. Dress your child in light clothing. Do not overwrap.
2. Give your child small drinks of clear fluid frequently. Do not worry if your child refuses to eat.
3. Keep your child cool, but cool them gently. Do not fan.
4. Give a children’s paracetamol medicine e.g. Calpol at the dose stated on the bottle or you can give Ibuprofen syrup (not if asthmatic) (NICE).
5. Repeat the dose 4 hourly until the temperature is normal and then 6 hourly for a further 24 hours.

Do not give children aspirin.
Do not exceed stated dose.
Keep medicines safe from children.

When to see your doctor

If you are concerned about any of the following:

1. Child looking sicker than previously, especially if pale when hot.
2. Complaints of stiff neck, light hurting eyes or a severe headache.
3. Unusual rash (especially if like a bruise).
4. Difficulty breathing.
5. Drinking less that ½ of normal intake in 24 hours or less than 4 wet nappies in 24 hours.
6. Vomiting.
7. Drowsiness.
8. No improvement after 48 hours.
9. Excessive pain.

If you are unsure of anything, please do not hesitate to telephone us. A nurse is always available to give advice and will be happy to help.

Contact us

Telephone: 0117 414 5100

© North Bristol NHS Trust. This edition published July 2022. Review due July 2025. NBT002254.

Our team is made up of several different members, as listed below.