Episode 1

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0:00:05 > 0:00:08From Headquarters just outside Barnsley, in South Yorkshire,

0:00:08 > 0:00:11a dedicated team of doctors and nurses fights

0:00:11 > 0:00:14to keep some of Britain's sickest children alive

0:00:14 > 0:00:17long enough to reach the specialist care they desperately need.

0:00:19 > 0:00:22If a child needs a life-saving operation...

0:00:22 > 0:00:23Down to ten, please.

0:00:23 > 0:00:26..or a premature baby has to be moved to a neonatal unit,

0:00:26 > 0:00:30it's the Embrace team's job to provide intensive care

0:00:30 > 0:00:32in the back of a moving ambulance,

0:00:32 > 0:00:34plane or helicopter.

0:00:35 > 0:00:37We've got a really precious patient here.

0:00:37 > 0:00:39He was just recently put on the transplant list.

0:00:39 > 0:00:41It's all happened very quickly, really.

0:00:41 > 0:00:44As the NHS concentrates specialist care

0:00:44 > 0:00:48for babies and children in fewer and bigger hospitals...

0:00:48 > 0:00:50Mick! Will you pull over, mate?

0:00:50 > 0:00:53..some of the UK's most vulnerable patients will need

0:00:53 > 0:00:56to undertake longer journeys to get expert care.

0:00:56 > 0:00:58BABY GARGLES

0:00:58 > 0:01:00You can hear him bubbling there.

0:01:00 > 0:01:05The big worry is that saliva will spill into his lungs

0:01:05 > 0:01:08and that's the most worrying thing for the journey.

0:01:08 > 0:01:10I love you, baby.

0:01:12 > 0:01:1424 hours a day, every day,

0:01:14 > 0:01:17Embrace is on standby,

0:01:17 > 0:01:19tiny lives in its hands.

0:01:19 > 0:01:21'Hello, Embrace. How can I help?'

0:01:28 > 0:01:30Good Evening, Embrace Transport Service. Stacey speaking.

0:01:30 > 0:01:32How can I help?

0:01:32 > 0:01:34The Embrace Transport Service for Yorkshire

0:01:34 > 0:01:37moves critically ill children aged zero to 16,

0:01:37 > 0:01:41but the majority are less than 28 days old.

0:01:41 > 0:01:44'We've got a patient on Ward 12 of the LGI

0:01:44 > 0:01:48'who's just gone onto the heart transplant list.

0:01:48 > 0:01:50'At any point, it may be that we're calling on you

0:01:50 > 0:01:55'to do an urgent transfer of him down to Great Ormond Street.'

0:01:55 > 0:01:58At 14 years, Chance is a more unusual Embrace patient.

0:01:58 > 0:02:02He has a rare condition which has badly damaged his heart.

0:02:02 > 0:02:07It's feared that, without a transplant, he has weeks to live.

0:02:07 > 0:02:12His heart had swollen so much, it wasn't beating.

0:02:12 > 0:02:17It was really just shuddering in his chest, really, it wasn't pumping.

0:02:17 > 0:02:22They did say, "We have to tell you that your son could die

0:02:22 > 0:02:27"if he doesn't get a transplant."

0:02:27 > 0:02:30Doctors at Leeds General Infirmary have contacted Embrace

0:02:30 > 0:02:33with the news that a donor heart has become available.

0:02:33 > 0:02:36But if Chance is to have this life-saving operation,

0:02:36 > 0:02:40surgeons need him to be at a specialist hospital 200 miles away

0:02:40 > 0:02:43within a five-hour window.

0:02:43 > 0:02:46And they need the Embrace team to get him there.

0:02:46 > 0:02:48'Just within the last half hour,

0:02:48 > 0:02:50'I had a phone call from Great Ormond Street,

0:02:50 > 0:02:53'from the transplant coordinator to say that, hopefully,'

0:02:53 > 0:02:56a heart has become available for Chance.

0:02:56 > 0:02:57Um... There's a very small window

0:02:57 > 0:03:01in which you've got to get things moving and get things in motion.

0:03:01 > 0:03:03It's 11.20 at night

0:03:03 > 0:03:06and the Embrace team heads to Leeds General Infirmary

0:03:06 > 0:03:09to meet up with Consultant Dr Hazel Talbot,

0:03:09 > 0:03:11who's come straight from home.

0:03:11 > 0:03:13- Hello!- Hello, Hazel.

0:03:13 > 0:03:16Hello! I didn't know who was coming.

0:03:16 > 0:03:18'The worry for me...well,

0:03:18 > 0:03:22'for everybody involved in Chance's care, was that'

0:03:22 > 0:03:26he was on the super-urgent list for a heart transplant

0:03:26 > 0:03:28and you don't go on the super-urgent list

0:03:28 > 0:03:31unless you really need a heart transplant.

0:03:34 > 0:03:37For Chance, that was his opportunity,

0:03:37 > 0:03:41that was his one opportunity, this is the final point for him -

0:03:41 > 0:03:43he needed a new heart.

0:03:46 > 0:03:50I think we're hoping that we're going to fly down.

0:03:50 > 0:03:53What's your time window that you're looking at, Karen?

0:03:55 > 0:03:58So the earlier we can get him to you, the better.

0:03:58 > 0:04:03The clock is ticking, so Embrace is drafting in an RAF helicopter,

0:04:03 > 0:04:05but it means subjecting a sick teenager,

0:04:05 > 0:04:07who's scarcely left his hospital bed in weeks,

0:04:07 > 0:04:10to a long flight in a noisy military aircraft.

0:04:12 > 0:04:17- 'Hello.- Hi, this is Tim phoning from the RAF Rescue Centre at Kinloss.

0:04:17 > 0:04:23'They can be at Leeds Bradford for a pick-up at 0100.'

0:04:23 > 0:04:28I woke Chance up, I said, "Chance," I said, "Come on, son."

0:04:28 > 0:04:31And he says, "No, no, no, go back home, Dad.

0:04:31 > 0:04:33"No, no, I'm going back to sleep."

0:04:33 > 0:04:36I says, "No, Chance, come on." I say, "Trust me, son."

0:04:36 > 0:04:40I said, "I always ask you to trust me, just trust me."

0:04:43 > 0:04:46If there isn't enough room for you both to travel,

0:04:46 > 0:04:48they'll send a car up for one of you.

0:04:48 > 0:04:51Well, they'll organise a car locally

0:04:51 > 0:04:53that will bring you down on blue lights.

0:04:53 > 0:04:55- Tomorrow?- Now.

0:04:55 > 0:04:58'We did need to go and Mum and Dad remained

0:04:58 > 0:05:00'really quite calm in the circumstances.'

0:05:00 > 0:05:04And I think they projected that for Chance as well to make him feel

0:05:04 > 0:05:05as comfortable as possible.

0:05:05 > 0:05:09Have the doctors ever let you listen to your heart before?

0:05:09 > 0:05:12- No.- Do you want to listen?

0:05:12 > 0:05:14Just stick those in your ears.

0:05:14 > 0:05:16You want a hand?

0:05:16 > 0:05:19- You got them in?- May be a bit low, Chance.- OK, can you hear that?

0:05:19 > 0:05:21It's going bloop-too, bloop-too...

0:05:21 > 0:05:25- Do you hear that, Chance? - That's your heart...

0:05:25 > 0:05:27beating away.

0:05:27 > 0:05:31'Chance was the same weight as my own son.

0:05:31 > 0:05:33'For me, that was quite nice,

0:05:33 > 0:05:36'because I could really feel a connection.'

0:05:36 > 0:05:39There's no pain in your tummy or anything?

0:05:39 > 0:05:42'Just typical teenager, just wanted me to go away.'

0:05:42 > 0:05:43I told you I talked a lot.

0:05:46 > 0:05:49Just sit up this end and then just slide your feet round

0:05:49 > 0:05:52and you'll have to tuck them under, can you manage to do that, Chance?

0:05:52 > 0:05:54MACHINE BEEPS

0:05:54 > 0:05:56Don't worry, that's just a noisy noise.

0:05:56 > 0:06:00It's now 12.30am and the transplant team in London needs Chance

0:06:00 > 0:06:04ready for his operation by four o'clock.

0:06:04 > 0:06:07That's it, just shuffle your bottom to the middle now, sweetheart.

0:06:07 > 0:06:08There you go.

0:06:08 > 0:06:09It's up to the Embrace team

0:06:09 > 0:06:12to not only get him there in time for the transplant,

0:06:12 > 0:06:16but to ensure that his condition remains stable until then.

0:06:16 > 0:06:18- Well done.- Right, now, do you want to sit up a bit more?

0:06:18 > 0:06:19BEEPING INTENSIFIES

0:06:19 > 0:06:21You're all right, are you?

0:06:21 > 0:06:24Don't worry, that's cos we've not got any monitoring going on it at the moment.

0:06:24 > 0:06:28The plan is to meet the RAF at Leeds Bradford at one o'clock,

0:06:28 > 0:06:30so we're going to have to get a move on.

0:06:30 > 0:06:33Chance is very nervous about flying,

0:06:33 > 0:06:37so his mum will travel in the helicopter with him.

0:06:37 > 0:06:39Bye-bye, Chance.

0:06:39 > 0:06:44'I sat down on the bed where he was laying.'

0:06:44 > 0:06:46Everything just hit me.

0:06:46 > 0:06:49To know that my son is going down to Great Ormond Street,

0:06:49 > 0:06:51but then I think to myself,

0:06:51 > 0:06:55"Am I going to see my son again?"

0:06:57 > 0:06:59SIREN WAILS

0:06:59 > 0:07:03'When they went, it was nothing but worries for me.'

0:07:03 > 0:07:06I...I couldn't stop shaking.

0:07:06 > 0:07:08It's unusual for the Embrace ambulance drivers

0:07:08 > 0:07:10to use lights and sirens,

0:07:10 > 0:07:13but Chance can't miss this flight from Leeds Bradford Airport.

0:07:13 > 0:07:15Mind the bump!

0:07:17 > 0:07:18It's fine. Please just let us in.

0:07:18 > 0:07:20We've got a really precious patient here.

0:07:20 > 0:07:22It's 1.15 in the morning.

0:07:22 > 0:07:24Chance has just two hours and 45 minutes

0:07:24 > 0:07:28to get to the heart waiting for him in London.

0:07:28 > 0:07:30- We'll get the trolley wheeled up to the aircraft.- Yeah.

0:07:30 > 0:07:33- We'll head first towards the aircraft.- Yeah.

0:07:33 > 0:07:36And we'll probably lift him on, purely because if we winch him

0:07:36 > 0:07:38we're likely to damage some of that kit.

0:07:38 > 0:07:42You all right, sweetheart? It's pretty cold in there, OK,

0:07:42 > 0:07:46so I'll wrap you up like a Christmas dinner!

0:07:46 > 0:07:50And have you got some ear defender for Chance, cos he's very anxious?

0:07:53 > 0:07:58The reason that Chance was going, was because he needed a heart that could pump harder.

0:07:59 > 0:08:02Chance, you OK? Want to hold my hand?

0:08:03 > 0:08:05AIR TRAFFIC CONTROL COMMUNICATION

0:08:06 > 0:08:10If he was going to get anxious and his heart rate was going to

0:08:10 > 0:08:13increase, that would put quite a strain on his heart.

0:08:14 > 0:08:18If his heart had stopped during the transfer,

0:08:18 > 0:08:21that's quite a tricky situation to be in, because the reason

0:08:21 > 0:08:25he was being transferred was because his heart wasn't strong enough.

0:08:25 > 0:08:29The only way we could get over that would be to have a heart transplant

0:08:29 > 0:08:31and that was the reason for the transfer.

0:08:31 > 0:08:35Chance has been relatively relaxed as you can be.

0:08:36 > 0:08:38There's a text message from his dad.

0:08:38 > 0:08:41I won't read it out, it's very, very sweet.

0:08:42 > 0:08:46I was texting his mum and saying, "how is he? How is he? How is he?"

0:08:46 > 0:08:50Tell him I love him and tell him just to be strong

0:08:50 > 0:08:54and not to worry about nothing, he's in good hands.

0:08:54 > 0:08:57I never thought about anything in terms of the transport, that he would die,

0:08:57 > 0:09:01because she was a doctor. The other two were nurses.

0:09:03 > 0:09:06After an hour and a quarter in the air, the Embrace team

0:09:06 > 0:09:11is on its final approach to London's Regent's Park, Great Ormond Street's landing site.

0:09:11 > 0:09:15Everyone involved in coordinating this transfer is aware

0:09:15 > 0:09:17of the seriousness of his condition

0:09:17 > 0:09:20but it's also vital to try to keep Chance feeling positive.

0:09:28 > 0:09:31It was a very different environment for us to work in.

0:09:31 > 0:09:34Even just talking to each other was quite difficult.

0:09:34 > 0:09:37I think somebody must have given the RAF a heads up about me,

0:09:37 > 0:09:39because my microphone didn't work

0:09:39 > 0:09:42so I could hardly talk during the whole of the flight.

0:09:42 > 0:09:44Which I think Anne and Jenny found amusing.

0:09:50 > 0:09:51That looks good there, now.

0:09:53 > 0:09:56Keep your cover back up, Chance, OK?

0:09:56 > 0:09:59- You all right? Not too cold?- No.

0:10:03 > 0:10:07- What time did you need to be here by, four?- Four-ish, yeah, what time is it? Just after three.

0:10:07 > 0:10:09- 3.10am.- We'll give it a go.

0:10:12 > 0:10:14You've been really good, haven't you?

0:10:17 > 0:10:20Embrace has worked closely with the hospital transplant team

0:10:20 > 0:10:26to ensure that Chance safely completes the final two-and-a-half miles of his life-changing journey.

0:10:26 > 0:10:28SIRENS

0:10:28 > 0:10:34I got a phone call about 1.30am asking me to go to Regents Park.

0:10:36 > 0:10:41And then we go on to collecting the surgical team and taking them to the hospital.

0:10:42 > 0:10:44It's just before 4.00am.

0:10:44 > 0:10:47Chance has made it in time for his transplant.

0:10:49 > 0:10:55He did say to me, "Mum, I don't want another person's heart."

0:10:55 > 0:10:58But he said, "I know I need one, don't I?" I said, "Yes you do."

0:10:58 > 0:11:00So he did know.

0:11:01 > 0:11:06He knew he wouldn't be leaving hospital without it.

0:11:08 > 0:11:11We just really had to worry about his comfort and his care.

0:11:11 > 0:11:14We just had to make sure he was comfortable

0:11:14 > 0:11:18and didn't get too anxious. And he coped with that very well.

0:11:18 > 0:11:21He had a little bit of sleep during that. It was very quiet.

0:11:21 > 0:11:25I think he's really tired now, he's probably very anxious.

0:11:25 > 0:11:27It's six-and-a-half hours

0:11:27 > 0:11:31since Chance left the Leeds General Infirmary in the Embrace ambulance.

0:11:31 > 0:11:34Now, after a flight on an RAF Sea King helicopter,

0:11:34 > 0:11:36he's lying in the operating theatre,

0:11:36 > 0:11:39where surgeons are giving him a new heart.

0:11:45 > 0:11:47I'm just wondering how big this baby is.

0:11:47 > 0:11:49I'm wondering if she should just take this?

0:11:49 > 0:11:53What makes Embrace different from the other patient transport services in England

0:11:53 > 0:11:57is that it moves any critically ill child aged 16 or under,

0:11:57 > 0:11:59including new-borns.

0:12:00 > 0:12:04Hello, it's Hazel here, one of the Embrace Consultants.

0:12:04 > 0:12:07Dr Hazel joined when it was first set up nearly four years ago.

0:12:09 > 0:12:12When a call comes in from a hospital, she decides

0:12:12 > 0:12:16if the patient needs to be moved to a specialist centre.

0:12:16 > 0:12:19And if the child or baby is very sick, she will do the transfer herself.

0:12:21 > 0:12:23You very quickly get used to the skill

0:12:23 > 0:12:27of assessing someone over the telephone,

0:12:27 > 0:12:29using another pair of eyes.

0:12:29 > 0:12:33Right, Tracey, who's going on this job?

0:12:33 > 0:12:36Is it Jamie and, um...Mick?

0:12:36 > 0:12:38Yeah, it will be Jamie and Mick.

0:12:38 > 0:12:42You get quite used to trying to work out what kind of equipment you might need,

0:12:42 > 0:12:47who your team members are going to be, what's the safest way to do it.

0:12:47 > 0:12:5170% of Embrace's patients are what doctors called neonates -

0:12:51 > 0:12:54babies less than 28 days old.

0:12:55 > 0:12:59And today staff at Scarborough Hospital have contacted Embrace

0:12:59 > 0:13:03about a baby born just four hours ago who urgently needs surgery.

0:13:05 > 0:13:09Right, so we need to come and collect your baby.

0:13:09 > 0:13:13I'm not quite sure how we'll be getting to you.

0:13:13 > 0:13:17But it's likely that we might fly up and fly him down to Hull.

0:13:19 > 0:13:22It's a two-hour drive to Scarborough, so to save time,

0:13:22 > 0:13:26Hazel drafts in The Children's Air Ambulance, a new helicopter charity

0:13:26 > 0:13:28which serves the whole of England.

0:13:29 > 0:13:32We're going to Scarborough, it's one of our furthest-away hospitals

0:13:32 > 0:13:36and we're going to take the baby a was born at 5 o'clock this morning

0:13:36 > 0:13:39who has oesophageal atresia.

0:13:39 > 0:13:42Which means that his oesophagus,

0:13:42 > 0:13:46that's your food pipe, isn't connected to his stomach,

0:13:46 > 0:13:49which means his secretions that he'd like to swallow build up

0:13:49 > 0:13:52and they spill over into the lungs and cause breathing problems.

0:13:55 > 0:13:59Ta-da! Where's the wing mirror so I can check what I look like.

0:13:59 > 0:14:01All right, pre-flight checks, please.

0:14:01 > 0:14:05You've got a little message above your head that says, "Get well soon."

0:14:05 > 0:14:09- OK, ladies, I shouldn't be any more than 20 minutes.- Great.

0:14:09 > 0:14:14A consultant is needed whenever the consultant decides the patient is sick enough.

0:14:14 > 0:14:18So if we can predict that a patient is going to be really sick, then we'll go out.

0:14:19 > 0:14:22Baby Gabor is just four hours old.

0:14:22 > 0:14:25His parents are Hungarian, Mum doesn't speak much English

0:14:25 > 0:14:29and Dad has had to go back to work straight after the birth.

0:14:30 > 0:14:36When I first met baby Gabor's mum, she looked so frail and tired.

0:14:36 > 0:14:38She'd just delivered a baby.

0:14:40 > 0:14:43I could see the tears in her eyes.

0:14:43 > 0:14:46And I thought, "Oh, you poor, poor lady."

0:14:48 > 0:14:51And as soon as the midwives are happy with you,

0:14:51 > 0:14:53then you can come to Hull too, not a problem.

0:14:53 > 0:14:56But we'll take him in the helicopter to Hull

0:14:56 > 0:14:58where they can have a look at him.

0:14:58 > 0:15:00All right? I'm going to examine him now.

0:15:00 > 0:15:04It's a very big stethoscope for a teeny baby, isn't it?

0:15:06 > 0:15:09So, that was a nice glob.

0:15:09 > 0:15:12I'm sure there's a technical term for a glob of mucus.

0:15:12 > 0:15:13I'm just going to move you, Mum.

0:15:13 > 0:15:16'The team in Scarborough had realised that there was a problem

0:15:16 > 0:15:20'and that they needed to put the repogle tube in

0:15:20 > 0:15:22'which is a tube that you can put into the pouch

0:15:22 > 0:15:24'where the saliva builds up

0:15:24 > 0:15:27'and you can suck that out and you can rinse that out as well.

0:15:27 > 0:15:30'So, putting that in is a really positive step.'

0:15:31 > 0:15:33Is Dad coming?

0:15:33 > 0:15:37- Dad's gone to work. - Dad's gone to work? Right.

0:15:37 > 0:15:39You can hear him bubbling there.

0:15:39 > 0:15:43GURGLING CRY

0:15:52 > 0:15:54All right, poppet.

0:15:54 > 0:15:57This is a potentially fatal condition.

0:15:57 > 0:15:59Gabor urgently needs surgery

0:15:59 > 0:16:03so he can swallow his own saliva instead of choking on it.

0:16:04 > 0:16:06All right. I know.

0:16:06 > 0:16:09OK. If you just put that down...

0:16:09 > 0:16:11OK, sweetie pie. I know.

0:16:11 > 0:16:13You're all bubbly, aren't you?

0:16:15 > 0:16:18- Or do you want him up...? That's a bit better.- Yes.

0:16:25 > 0:16:27Oh, sweetheart.

0:16:27 > 0:16:30HE CRIES

0:16:33 > 0:16:37That is the secretions stuck in his throat,

0:16:37 > 0:16:39so they're building up because he can't swallow them.

0:16:39 > 0:16:43You'd be amazed how important being able to swallow your secretions is.

0:16:46 > 0:16:50I know. I'm so sorry that we have to take him, but it's really important.

0:16:50 > 0:16:53Always check in, yeah? Any time.

0:16:53 > 0:16:57I will try and ring you to tell you that we have arrived.

0:16:57 > 0:17:00The big worry for Gabor is that

0:17:00 > 0:17:04his spit, his saliva,

0:17:04 > 0:17:06will spill into his lungs.

0:17:06 > 0:17:10'I had to just think, I'll just be as simple as I can

0:17:10 > 0:17:12'and I'll just do the best that I can,'

0:17:12 > 0:17:17but I'm not sure I'm going to be able to make her feel any better.

0:17:19 > 0:17:21I love you, baby.

0:17:34 > 0:17:37'You have to be able to understand what they're going through...

0:17:37 > 0:17:40SHE SOBS

0:17:40 > 0:17:43'..but our number-one priority is moving the child or a baby.

0:17:43 > 0:17:47'You can't let your emotions interfere with that process.'

0:17:50 > 0:17:53Just before take off, Baby Gabor starts choking again.

0:17:55 > 0:17:58- Sats are 88 now. I'm not happy for you to start.- OK.

0:17:58 > 0:18:00If you wouldn't mind not starting?

0:18:00 > 0:18:03Do you want to suction his mouth?

0:18:03 > 0:18:05'When you're actually in the helicopter,

0:18:05 > 0:18:10'you can't move around very much. You have to constantly watch them.

0:18:10 > 0:18:11'You can't just ask the pilot to stop

0:18:11 > 0:18:14'so that you can have a good look at the patient.

0:18:14 > 0:18:16'So, there is that difference, you have to make sure

0:18:16 > 0:18:20'that everything is tiptop before you get in.'

0:18:20 > 0:18:23It's vital that Hazel keeps Gabor's windpipe clear,

0:18:23 > 0:18:24otherwise he could suffocate.

0:18:26 > 0:18:28During the flight, we did a few flushes

0:18:28 > 0:18:30and he was just up and down a little bit.

0:18:30 > 0:18:33Every now and again, it just gets blocked up.

0:18:34 > 0:18:37Babies don't tell you, "I don't really feel very well.

0:18:37 > 0:18:40"My tummy's upset and I've got some pain in my tummy."

0:18:40 > 0:18:43They have no way of communicating with you, so it's about monitoring

0:18:43 > 0:18:46the babies and treating them gently and watching them.

0:18:48 > 0:18:50Unlike Scarborough, Hull Royal Infirmary

0:18:50 > 0:18:54has a level-three neonatal intensive care unit.

0:18:54 > 0:18:57That means the most critically-ill babies can be cared for here.

0:18:57 > 0:19:01Some neonatal surgery can also be carried out at this hospital,

0:19:01 > 0:19:04although more complex cases will be sent to Leeds or Sheffield,

0:19:04 > 0:19:0660 miles away.

0:19:08 > 0:19:12His heart looks a little bit globular, but good femorals,

0:19:12 > 0:19:14no murmur. I think he'll need an echo.

0:19:14 > 0:19:17Mr Fleet was a bit concerned he might be a little bit more complicated.

0:19:17 > 0:19:21- GURGLING CRY - Oh, hello!- OK, sweet boy.

0:19:23 > 0:19:24- Got him?- Yep.

0:19:26 > 0:19:30Have you got some suction handy? I just want to suction his mouth out.

0:19:30 > 0:19:32Yep, got it.

0:19:32 > 0:19:34Baby Gabor needs surgery straightaway

0:19:34 > 0:19:36to connect his oesophagus to his stomach.

0:19:40 > 0:19:43Sometimes they can't do it in one operation.

0:19:43 > 0:19:44It depends how big the gap is

0:19:44 > 0:19:47between the two ends of the oesophagus.

0:19:47 > 0:19:49If the gap's too big, they can't stretch it to join,

0:19:49 > 0:19:52so they will need further surgery.

0:19:52 > 0:19:55The theatres are ready, the surgeons have been,

0:19:55 > 0:19:57the anaesthetist has been,

0:19:57 > 0:20:00bloods have been taken, so we're ready to go.

0:20:04 > 0:20:08Every year, this NHS-funded mobile intensive care team

0:20:08 > 0:20:12transports over 2,000 sick babies and children

0:20:12 > 0:20:15to specialist centres in their adapted ambulances.

0:20:17 > 0:20:21Critical care consultant Steve Hancock helped set the service up and now runs it.

0:20:23 > 0:20:26From the outside, they look like a normal 999 ambulance.

0:20:26 > 0:20:29But inside, they're a mobile intensive care unit

0:20:29 > 0:20:33for premature babies and critically-ill children.

0:20:33 > 0:20:35It's the medical air that's so important

0:20:35 > 0:20:39because newborn babies are actually quite vulnerable to having

0:20:39 > 0:20:42too much oxygen and if you give too much oxygen to a premature baby,

0:20:42 > 0:20:45you can damage their eyes and their lungs.

0:20:45 > 0:20:50As specialist paediatric services are concentrated in fewer hospitals,

0:20:50 > 0:20:54these young patients are facing longer, more frequent journeys.

0:20:55 > 0:20:58If we need to move a child to Newcastle or to London

0:20:58 > 0:21:03or to Glasgow, then we can do that, and because this is our job,

0:21:03 > 0:21:07this is what we do, it means that all the other doctors and nurses

0:21:07 > 0:21:09in the referral unit or the receiving unit

0:21:09 > 0:21:13can carry on looking after the other patients while we do the transfer.

0:21:13 > 0:21:17That, I think, is a real benefit.

0:21:17 > 0:21:19And the children arrive in better condition

0:21:19 > 0:21:21than if it was a non-specialist team.

0:21:24 > 0:21:26Long day, too.

0:21:26 > 0:21:29We're planning on a transfer of a child

0:21:29 > 0:21:32that Vikram and I transferred a few days ago...

0:21:32 > 0:21:35The majority of the hundreds of road trips

0:21:35 > 0:21:38Embrace makes every year are within Yorkshire.

0:21:39 > 0:21:42But today a specialist team is driving 120 miles

0:21:42 > 0:21:44from Barnsley to Newcastle

0:21:44 > 0:21:47to collect a child who lives near Sheffield

0:21:47 > 0:21:50but has become ill while on a family holiday.

0:21:53 > 0:21:57Nine-year-old Katerina is in remission from leukaemia,

0:21:57 > 0:21:59but a seizure she had on the first night of her trip

0:21:59 > 0:22:03to the North-East indicates her cancer could be back.

0:22:04 > 0:22:08They'd been concerned that the scan she had in Newcastle was abnormal,

0:22:08 > 0:22:12but I think their overriding concern was whether or not

0:22:12 > 0:22:15she'd had a recurrence of the leukaemia, which was why

0:22:15 > 0:22:18it was paramount to get her back to Sheffield,

0:22:18 > 0:22:20to the team that knew her best.

0:22:20 > 0:22:23Doctors at the Childhood Cancer Centre

0:22:23 > 0:22:26at Sheffield Children's Hospital have been treating Katerina

0:22:26 > 0:22:30since she was first diagnosed nearly a year ago.

0:22:30 > 0:22:33The family is now facing the possibility

0:22:33 > 0:22:35that Katerina may never recover.

0:22:36 > 0:22:40My hand started shaking and I thought, "That's not right."

0:22:40 > 0:22:44Then it started doing that. Then my head started shaking.

0:22:44 > 0:22:47I just knew immediately what was happening.

0:22:47 > 0:22:49Called my brother-in-law

0:22:49 > 0:22:51and my sister-in-law to call for an ambulance

0:22:51 > 0:22:53and it just went really quickly from there.

0:22:53 > 0:22:55Who's this?

0:22:55 > 0:22:59Have you got names? You must have names!

0:22:59 > 0:23:02I've got that many teddies, I haven't given him a name.

0:23:02 > 0:23:04They're all lovely, aren't they? Can I have a look?

0:23:04 > 0:23:07You obviously treat all children the same, but I think

0:23:07 > 0:23:11some of them just make you smile that bit more.

0:23:11 > 0:23:13All right. Well, if you hang on just a little bit

0:23:13 > 0:23:17and then Kirsty will come back and sort this...

0:23:17 > 0:23:21fluids out for you and then we'll get you onto the trolley, all right?

0:23:23 > 0:23:26Over the last ten months of serious illness,

0:23:26 > 0:23:28Katerina has had much to endure.

0:23:28 > 0:23:32Tired and hungry, she now faces a long journey ahead.

0:23:32 > 0:23:36- KATERINA SOBS - I've had enough medicine now.

0:23:36 > 0:23:41- It's awful.- All right. - I don't want to have this.

0:23:41 > 0:23:44SHE SOBS

0:23:44 > 0:23:46Listen, they're not starving you.

0:23:46 > 0:23:49Listen... Sshhhh.

0:23:49 > 0:23:53- Katerina...- Darling, we just don't want you to be sick in the ambulance

0:23:53 > 0:23:56- and feel poorly. - I'm not going to be sick.

0:23:56 > 0:23:59OK. But what we're going to do, we're going to carry them

0:23:59 > 0:24:01and then you can suck on a sweetie...

0:24:01 > 0:24:05'You feel really cruel and mean, denying them something

0:24:05 > 0:24:07'that's going to keep them comfortable

0:24:07 > 0:24:11'and they may not appreciate the reason for us doing that.

0:24:11 > 0:24:13'Obviously, she's in the back of an ambulance'

0:24:13 > 0:24:16which was going to be quite hot, she's travelling backwards

0:24:16 > 0:24:19and we didn't know how well she was going to cope with that

0:24:19 > 0:24:21and what we didn't want to do

0:24:21 > 0:24:24was to make her feel worse during the transfer.

0:24:24 > 0:24:27It's obviously quite a long journey from Newcastle down to Sheffield.

0:24:32 > 0:24:33It's a gruelling three-hour trip

0:24:33 > 0:24:37from Newcastle to the Children's Hospital in Sheffield

0:24:37 > 0:24:39and it doesn't help that, for once, the country is experiencing

0:24:39 > 0:24:44a summer heat wave. Temperatures are pushing 25 degrees Celsius.

0:24:45 > 0:24:48Do you want to press the climate...? No, green one. Green one.

0:24:48 > 0:24:52Yeah, you want that one as well. That's the one. That's it.

0:24:53 > 0:24:56So, we won't be able to talk for a very much, I'm afraid.

0:24:56 > 0:24:58It's a bit noisy in the ambulance.

0:24:58 > 0:25:01But you'll be able to see each other and have a little chat.

0:25:01 > 0:25:03She might actually sleep.

0:25:08 > 0:25:12'I don't think it was a comfortable day for anybody in the ambulance.

0:25:12 > 0:25:16'It was a particularly hot day and unfortunately, there's not a lot of ventilation

0:25:16 > 0:25:18'in the back of an ambulance, so it does get quite hot

0:25:18 > 0:25:20'and it's obviously quite a long journey.'

0:25:26 > 0:25:31They took us aside and they did talk about the possibility of leukaemia

0:25:31 > 0:25:33returning in the brain.

0:25:33 > 0:25:38We had to go back to Sheffield immediately for more tests

0:25:38 > 0:25:40and more recent scans

0:25:40 > 0:25:47and that's where the Embrace team came to take us and save us.

0:25:50 > 0:25:53It won't be long till we get there, pet.

0:25:53 > 0:25:56KATERINA SOBS

0:25:56 > 0:26:00We will give them to her before she gets there.

0:26:00 > 0:26:03She can have them beforehand. Just a little bit longer,

0:26:03 > 0:26:06and then we'll give them to you, all right, Katerina?

0:26:09 > 0:26:10We will. We promise.

0:26:13 > 0:26:18'We didn't tell her at the time that she may have leukaemia.

0:26:18 > 0:26:20'She didn't ask.'

0:26:24 > 0:26:27It just wasn't fair, we were starving her,

0:26:27 > 0:26:30but she's all right now.

0:26:30 > 0:26:32She's had a good sleep, actually.

0:26:32 > 0:26:37'It must be difficult for all of them in their own ways,

0:26:37 > 0:26:40'but I think it was lovely that the family were obviously a very close-knit family

0:26:40 > 0:26:43'and very supportive of each other and they had'

0:26:43 > 0:26:48a lovely relationship between all of them which was really lovely to see.

0:26:48 > 0:26:51Close in, sweetheart. That's it. Excellent.

0:26:51 > 0:26:55Over the next few days, the family is going to need all its strength.

0:26:55 > 0:26:58Doctors are about to carry out a series of tests that will reveal

0:26:58 > 0:27:00whether Katerina's cancer has returned.

0:27:15 > 0:27:18At Great Ormond Street Hospital in London,

0:27:18 > 0:27:21just ten hours after being flown in by the Embrace team

0:27:21 > 0:27:24on an RAF helicopter, 14-year-old Chance has had

0:27:24 > 0:27:26his heart transplant operation.

0:27:29 > 0:27:32I think it went really well. We received the organ in good time

0:27:32 > 0:27:35and critically, it was a good size match between the donor

0:27:35 > 0:27:38and the recipient, so the new heart fits

0:27:38 > 0:27:42very well into the chest. Then, once we managed to wean him

0:27:42 > 0:27:45off the bypass machine, the new heart actually

0:27:45 > 0:27:48took over very, very quickly and it had a very good blood pressure

0:27:48 > 0:27:51to it, which is suggestive of its health

0:27:51 > 0:27:53and I think it was as good as it could be.

0:27:57 > 0:28:00I have a sister and she came to stay with me.

0:28:02 > 0:28:06Lots of deep breaths, telling yourself to keep calm, calm down.

0:28:09 > 0:28:12In a way, you just think, "Well...

0:28:12 > 0:28:15"look what I'm going through, but I'm not going through

0:28:15 > 0:28:18"what my son's going through."

0:28:18 > 0:28:21That was the only way I could deal with it, really.

0:28:21 > 0:28:24If Chance can deal with this, then I can.

0:28:27 > 0:28:30I just came to the hospital after the operation and...

0:28:30 > 0:28:36I see Lisa and her sister Deborah sat down there, beside my son.

0:28:36 > 0:28:39I thought, "Is that my son on that table?"

0:28:39 > 0:28:44It's something you can't describe, that pain, the feeling,

0:28:44 > 0:28:45you know what I mean?

0:28:48 > 0:28:53The first 30 days after a heart transplant are the riskiest.

0:28:53 > 0:28:56Chance spends the next three weeks in Great Ormond Street

0:28:56 > 0:28:58being closely monitored for any indication

0:28:58 > 0:29:00that his body may be rejecting his new heart.

0:29:05 > 0:29:10You just hope that the heart that he's got is going to settle

0:29:10 > 0:29:13and is going to be OK with him.

0:29:13 > 0:29:17Is he going to accept this heart?

0:29:17 > 0:29:18Is he going to reject it?

0:29:18 > 0:29:20Is it going to be OK?

0:29:21 > 0:29:24To see my little boy pull through

0:29:24 > 0:29:29and to the family who's giving him this heart,

0:29:29 > 0:29:32it's the greatest gift they've ever given to my son

0:29:32 > 0:29:37because they've given my son back to me and that's the best.

0:29:38 > 0:29:41The worst bit was kind of like...

0:29:42 > 0:29:45..the first part after the operation.

0:29:50 > 0:29:56Now things are getting better and I go home soon.

0:30:04 > 0:30:06When a critically ill child or baby in Yorkshire

0:30:06 > 0:30:09needs to be moved to a specialist hospital,

0:30:09 > 0:30:13the call comes in here to Embrace headquarters near Barnsley.

0:30:15 > 0:30:17Good morning, it's Rebecca at Embrace.

0:30:17 > 0:30:20- I'm good, thanks, how are you? - Fine, thank you.- Good.

0:30:20 > 0:30:22What are you like bed-wise today?

0:30:24 > 0:30:27One Intensive and six Special. Yeah, that's great.

0:30:29 > 0:30:33All the ambulances are checked every day before we go out.

0:30:33 > 0:30:37We are like coiled springs should an emergency occur.

0:30:37 > 0:30:40It's like origami for the bewildered!

0:30:40 > 0:30:43All 40 doctors and nurses here

0:30:43 > 0:30:47are trained in critical care paediatric and neonatal patients.

0:30:49 > 0:30:50My name's Ann Jackson,

0:30:50 > 0:30:53I'm one of the senior transport nurses here at Embrace.

0:30:53 > 0:30:56Most of my nursing career has been with paediatrics,

0:30:56 > 0:30:58and prior to coming to Embrace I worked on IC

0:30:58 > 0:31:01at Sheffield's Children's Hospital for about 17 years.

0:31:01 > 0:31:03We are just putting Embrace 2 in there to restock it

0:31:03 > 0:31:05cos it's back and is better.

0:31:07 > 0:31:09When you've just got one child to look after

0:31:09 > 0:31:11you can give them absolutely 100%.

0:31:11 > 0:31:13They cope remarkably well with illnesses,

0:31:13 > 0:31:15much better than we do as adults.

0:31:16 > 0:31:20Oh, look at this. It's just like packing to go on holiday now.

0:31:21 > 0:31:22Right...

0:31:23 > 0:31:26How fast can we do this, then, Clive?

0:31:26 > 0:31:29But there will be no time for Ann and the team to do the housekeeping,

0:31:29 > 0:31:32as a call comes in from Barnsley Hospital.

0:31:32 > 0:31:35Doctors there are very concerned

0:31:35 > 0:31:38about a two-day-old baby who's having seizures.

0:31:38 > 0:31:42In a child this young, frequent fits can indicate brain damage.

0:31:42 > 0:31:46MAN. 'He kept on having these frequent episodes,

0:31:46 > 0:31:50'like every half an hour or so he had an episode of this

0:31:50 > 0:31:53'although the heart rate remained stable.'

0:31:53 > 0:31:58This is a little baby boy that was born two days ago at Barnsley,

0:31:58 > 0:32:01who's been having some problems with seizures, fits.

0:32:01 > 0:32:04He's deteriorated from a respiratory point of view,

0:32:04 > 0:32:06so he's ended up on a ventilator.

0:32:08 > 0:32:11Nurse Ann and her colleague Ann Kelly,

0:32:11 > 0:32:14who is an advanced nurse practitioner, will take the baby

0:32:14 > 0:32:17to one of the biggest neonatal units in the North,

0:32:17 > 0:32:19at the Jessop Wing Hospital in Sheffield.

0:32:20 > 0:32:22Barnsley have done some investigations

0:32:22 > 0:32:25and are waiting for results, but Jessops need to do further

0:32:25 > 0:32:27investigations and ongoing management.

0:32:27 > 0:32:29So we're going down to Barnsley and make sure he's stable

0:32:29 > 0:32:31and then transfer him across.

0:32:37 > 0:32:40Barnsley Hospital is a ten-minute drive from Embrace,

0:32:40 > 0:32:44and the Jessop Wing Hospital is only 15 miles down the motorway.

0:32:44 > 0:32:47But moving a baby can take several hours.

0:32:49 > 0:32:50We are very keen on safety,

0:32:50 > 0:32:53so we have an attitude of it takes as long as it takes.

0:32:55 > 0:32:59- Did they say what fluids he was on in terms of mils per kilo?- No.

0:32:59 > 0:33:02We want to move these children as swiftly as we can,

0:33:02 > 0:33:06but if it takes an hour or six hours, then that's what it takes,

0:33:06 > 0:33:09because they don't want to move them until they are absolutely ready.

0:33:09 > 0:33:12So...unplugged.

0:33:12 > 0:33:14Brakes off. Happy at your side?

0:33:16 > 0:33:21Since he was born, 48 hours ago, baby Jackson has had several fits

0:33:21 > 0:33:24which have caused him to stop breathing.

0:33:24 > 0:33:27He's also holding his thumbs in an unusual way.

0:33:29 > 0:33:31It's very well tucked in, that thumb, isn't it?

0:33:31 > 0:33:33Is it tucked in on the other side as well?

0:33:35 > 0:33:38The concern with baby Jackson was that there was

0:33:38 > 0:33:40some degree of brain damage somewhere,

0:33:40 > 0:33:43either caused by the birth process or infection

0:33:43 > 0:33:47or some undiagnosed neurological condition that needed investigating.

0:33:47 > 0:33:50Because certainly some of the symptoms he was displaying,

0:33:50 > 0:33:53particularly with his tucked-in thumbs, it's a very abnormal sign.

0:33:53 > 0:33:55Oooh!

0:33:57 > 0:34:00I like the Batman look. He's been under the lights, hasn't he?

0:34:00 > 0:34:02Taking your temperature, sweetie pie.

0:34:03 > 0:34:07As the team swaps baby Jackson from the hospital breathing machine,

0:34:07 > 0:34:10or ventilator, onto the Embrace ventilator, there's a crisis.

0:34:10 > 0:34:13RAPID BEEPING

0:34:16 > 0:34:18Heart rate is 78.

0:34:18 > 0:34:22- Yeah, I think this tube is out. Have you got his mask?- OK.

0:34:22 > 0:34:26Maybe Jackson isn't getting any air at all into his lungs.

0:34:26 > 0:34:29He's coughed at the breathing tube that connects him to the ventilator.

0:34:32 > 0:34:34You've got to keep one step ahead with the little ones

0:34:34 > 0:34:37because anything can happen at any time.

0:34:37 > 0:34:40Are you happy with the ambi bag?

0:34:40 > 0:34:43The adrenaline and your heart rate goes up and you think,

0:34:43 > 0:34:47"Oh, gosh," but it's controlled. It's scary, but it's controlled,

0:34:47 > 0:34:50because you've got everything there you need to deal with it.

0:34:53 > 0:34:55Back to 98. Heart rate's fine at 158.

0:34:55 > 0:34:57His tube had come out,

0:34:57 > 0:35:00but we managed to control his breathing just by bagging him

0:35:00 > 0:35:03by hand until we got the equipment ready to put another tube down.

0:35:03 > 0:35:05The numbers and everything are fine

0:35:05 > 0:35:08and the situation is under control, but we've asked for

0:35:08 > 0:35:11some assistance now because we need to put a new tube down.

0:35:11 > 0:35:13He's fine. It just delays us a little bit longer,

0:35:13 > 0:35:16but he's OK and that's all that matters.

0:35:18 > 0:35:20The doctor on the neonatal unit puts another tube

0:35:20 > 0:35:24down Jackson's windpipe and now he's almost ready to move.

0:35:25 > 0:35:28Just have a quick word with Mum and tell her what happening,

0:35:28 > 0:35:32because she's sat out there wondering why the door is closed.

0:35:32 > 0:35:35When we're working with babies or children,

0:35:35 > 0:35:38time goes very quickly for us, particularly when there is a lot to do,

0:35:38 > 0:35:41but for parents that clock ticks very slowly.

0:35:41 > 0:35:44For baby Jackson they've been called in from home,

0:35:44 > 0:35:47so they were very stressed when they arrived on the unit anyway.

0:35:47 > 0:35:49And as a parent - and I'm sure I'd be the same -

0:35:49 > 0:35:51if the door is closed, I think you always assume

0:35:51 > 0:35:54that there's something wrong, something seriously wrong.

0:35:54 > 0:35:58So what he's done is he's coughed his tube out.

0:35:58 > 0:36:01He'll get his bottom slapped. It's not a problem, right?

0:36:01 > 0:36:04We've just popped another tube back down.

0:36:07 > 0:36:11He's giving me his wild look. He's got one eye open and one eye shut.

0:36:13 > 0:36:16Finally, after three-and-a-half hours,

0:36:16 > 0:36:19they are ready to take Jackson to the Jessop Wing hospital in Sheffield.

0:36:19 > 0:36:21One, two, three.

0:36:23 > 0:36:25Come on, then.

0:36:25 > 0:36:27In you go.

0:36:28 > 0:36:29Good lad.

0:36:29 > 0:36:32We'll turn your head, mister, and then we'll get this door shut.

0:36:32 > 0:36:35Once the Embrace medics are on the road,

0:36:35 > 0:36:38they operate as a mobile Intensive Care Unit,

0:36:38 > 0:36:41but with a fraction of the resources of the hospital.

0:36:41 > 0:36:43Thank you very much.

0:36:43 > 0:36:46- I don't think we've left too much of a mess, have we?- No, it's fine.

0:36:46 > 0:36:48Thank you. Cheers, bye.

0:36:48 > 0:36:51Only one patient has died en route

0:36:51 > 0:36:54since the service was set up nearly four years ago.

0:36:54 > 0:36:56Ann Jackson remembers it well.

0:36:58 > 0:37:02It's horrible. It's horrible, because it's not what should happen.

0:37:04 > 0:37:07I think with that particular child we knew the risks were high.

0:37:07 > 0:37:09The family knew the risks were high.

0:37:09 > 0:37:12But it was the baby's only chance of surviving, so it was with

0:37:12 > 0:37:16the family's consent, in fact their wishes, that we moved the baby.

0:37:16 > 0:37:19It doesn't make it any easier when you lose them.

0:37:22 > 0:37:23We cried with the parents.

0:37:23 > 0:37:25And I'm not ashamed to say that

0:37:25 > 0:37:28because I think that makes them really realise that you do care.

0:37:28 > 0:37:30That is not just another baby.

0:37:30 > 0:37:32But you have to be careful

0:37:32 > 0:37:36because they're the ones that have lost the baby. It's their child.

0:37:36 > 0:37:38We are the transport team.

0:37:38 > 0:37:42So it's getting that balance between sympathising, holding,

0:37:42 > 0:37:45saying the right things, but then drawing back a little bit

0:37:45 > 0:37:47and recognising their grief.

0:37:47 > 0:37:49But it affects the team hugely.

0:37:53 > 0:37:56Ray, hi, it's Ann. We've arrived at Jessop's.

0:37:56 > 0:37:59Thankfully, like most of the specialist team's patients,

0:37:59 > 0:38:02baby Jackson has had an uneventful journey.

0:38:05 > 0:38:09Right, this is Jackson. Mum and Dad are on the way.

0:38:09 > 0:38:13We've told them he's been moved because of his abnormal murmurs.

0:38:13 > 0:38:15I don't think they really understand

0:38:15 > 0:38:17the significance at the moment.

0:38:17 > 0:38:21Dad picked up on his thumbs being tucked in and said,

0:38:21 > 0:38:23"Is that normal?" and we said it wasn't

0:38:23 > 0:38:26and that's partly why he needs further investigation.

0:38:26 > 0:38:28But he's their first child.

0:38:28 > 0:38:30So they are on their way across.

0:38:31 > 0:38:34As the transport team hands over to staff on the hospital's

0:38:34 > 0:38:38neonatal unit, baby Jackson's parents still don't really know

0:38:38 > 0:38:41how sick their child might really be.

0:38:41 > 0:38:43In you go. Good lad.

0:38:45 > 0:38:47Doctors will carry out more tests,

0:38:47 > 0:38:51hoping they can at least rule out permanent brain damage.

0:38:51 > 0:38:54Saturations are rising. Good lad.

0:39:06 > 0:39:10Baby Gabor's parents are Hungarian and speak little English.

0:39:10 > 0:39:13Just hours after he was born, their baby had to be whisked away

0:39:13 > 0:39:18for an urgent operation to connect his oesophagus to his stomach.

0:39:19 > 0:39:21I love you, baby...

0:39:24 > 0:39:27They arrived here at Hull Royal Infirmary just as their new baby

0:39:27 > 0:39:29was coming out of the operating theatre.

0:39:31 > 0:39:35The operation involved opening the chest, finding this blind,

0:39:35 > 0:39:38and...his oesophagus

0:39:38 > 0:39:43and finding the connection between the oesophagus and the trachea.

0:39:43 > 0:39:48Tied that what we call fistula to prevent any further air

0:39:48 > 0:39:52going into the stomach and then bringing those two ends together,

0:39:52 > 0:39:58to do continuity, and allow the baby to be fed in future.

0:39:59 > 0:40:05Everything went all right. We haven't had any surprises.

0:40:05 > 0:40:06Gabor, I would say,

0:40:06 > 0:40:10is lucky that he doesn't have any other abnormalities so far detected.

0:40:10 > 0:40:15And he is growing and we do hope that in future

0:40:15 > 0:40:17he will not have any further problem.

0:40:18 > 0:40:21MOTHER SPEAKS HUNGARIAN

0:40:21 > 0:40:23- TRANSLATOR.- I was very anxious on the journey to hospital,

0:40:23 > 0:40:27and when we arrived there we saw the little one was unwell.

0:40:27 > 0:40:30But I was also pleased because there he was in front of me.

0:40:30 > 0:40:32The operation had been successful.

0:40:32 > 0:40:34The doctors told us right away

0:40:34 > 0:40:36everything that had happened,

0:40:36 > 0:40:37what could happen

0:40:37 > 0:40:42and what to expect throughout the following couple of days.

0:40:42 > 0:40:45Finally, after two weeks in hospital, Gabor's happy

0:40:45 > 0:40:48and relieved parents can take their first-born home.

0:40:51 > 0:40:52It was difficult.

0:40:52 > 0:40:55I was a bit afraid whether I could look after him

0:40:55 > 0:40:57because I had to get to know the baby.

0:40:57 > 0:41:00There really was just two of us and there was no-one else.

0:41:00 > 0:41:03There was no doctor to ask if I didn't know something.

0:41:09 > 0:41:13She said everywhere is good, but the best at home.

0:41:22 > 0:41:26Every year, the Embrace teams make over 2,000 journeys moving

0:41:26 > 0:41:30critically ill babies and children to and from hospitals in Yorkshire.

0:41:32 > 0:41:35You should maybe have led the way.

0:41:35 > 0:41:37In the biggest centres, like Leeds General Infirmary,

0:41:37 > 0:41:41even experienced Embrace nurses like Suzanne can lose their way.

0:41:42 > 0:41:46It took me a little while to get used to the hospital,

0:41:46 > 0:41:49but now, after three years, you do get used to it.

0:41:49 > 0:41:53This is a new unit, though, so it's the first time I've been here.

0:41:53 > 0:41:55Hello!

0:41:55 > 0:41:58I'm going to take you over in the ambulance.

0:42:00 > 0:42:02Is this your nice blanket?

0:42:02 > 0:42:04Kyreece is six years old.

0:42:04 > 0:42:08He was starved of oxygen at birth and suffered brain damage.

0:42:08 > 0:42:11'When he was born, he had a flappy larynx,'

0:42:11 > 0:42:15which is too much skin over the windpipe.

0:42:15 > 0:42:18And he just got quite poorly after that operation

0:42:18 > 0:42:24and he ended up losing his eyesight and most of his mobility.

0:42:24 > 0:42:26The nurse is just going to tell me a nice long story

0:42:26 > 0:42:30and then we'll come and get you over.

0:42:30 > 0:42:32- OK?- Yeah.- Yeah?

0:42:32 > 0:42:34You're a clever boy.

0:42:34 > 0:42:39A week ago, Kyreece developed an infection and almost died.

0:42:39 > 0:42:45He was quite swollen from his neck upwards and he was quite grey

0:42:45 > 0:42:48and there was just no breath there.

0:42:48 > 0:42:52I rang the ambulance and they said I had to give him CPR.

0:42:53 > 0:42:56And as he kind of... not woke up, but came round,

0:42:56 > 0:42:58he went straight into a fit.

0:42:59 > 0:43:02And things went quite downhill from there and he ended up

0:43:02 > 0:43:04on life support.

0:43:04 > 0:43:05Over the next few days

0:43:05 > 0:43:09Kyreece recovered from the infection and now he's well enough to be

0:43:09 > 0:43:14moved to Martin House, a children's hospice 15 miles outside Leeds.

0:43:16 > 0:43:19Ohhh... There's a nice bed.

0:43:20 > 0:43:23This is a different bed for you, Kyreece.

0:43:23 > 0:43:27'I don't have any children of my own but I enjoy the company of children.

0:43:27 > 0:43:30'I do have nieces and a nephew that I spend a lot of time with,'

0:43:30 > 0:43:34so that's helped as well, so I know what children of Kyreece's age

0:43:34 > 0:43:36are like and what's interesting to them.

0:43:37 > 0:43:39Are you going in the big special car?

0:43:41 > 0:43:45Mum will see you in a minute. 30 minutes, OK?

0:43:45 > 0:43:47- Yeah.- Love you.

0:43:50 > 0:43:53He should be all right. As long as he's got them, he should be fine.

0:43:56 > 0:43:58If he likes music, we might sing to him.

0:43:58 > 0:44:00- Yeah, he...- Does he like songs? - He does.

0:44:00 > 0:44:04- He likes Happy Birthday and Jingle Bells.- All right.

0:44:04 > 0:44:07- They're his favourites at the moment.- We'll try them if we need them.

0:44:07 > 0:44:11- If he starts getting cross just don't sing owt. - Just leave him be.

0:44:11 > 0:44:15And he likes it if you tell him what different animal noises do.

0:44:15 > 0:44:17- Oh, that's a good one.- All right.

0:44:17 > 0:44:20She was really quite reluctant to leave him

0:44:20 > 0:44:23and it's obvious that he is the apple of her eye,

0:44:23 > 0:44:26that her whole life revolves around him.

0:44:26 > 0:44:29And I can understand why. He's a very charming boy.

0:44:29 > 0:44:32She has dedicated her life to Kyreece.

0:44:32 > 0:44:36And it came across in the way they interacted

0:44:36 > 0:44:39and it was just beautiful to see them as a family unit.

0:44:44 > 0:44:46ELECTRONIC VOICE

0:44:46 > 0:44:49- Are you pressing the buttons? - Yes.- Yes?

0:44:49 > 0:44:52- MUM.- You're scared because they are

0:44:52 > 0:44:55with someone they've never met before.

0:44:55 > 0:44:57- Are you OK?- Yes.

0:44:57 > 0:45:00Yes. Oh, that's a good boy.

0:45:00 > 0:45:02You've got to have that faith.

0:45:02 > 0:45:05You have to have that belief of he will be OK

0:45:05 > 0:45:07and I'm not far behind him.

0:45:08 > 0:45:12Kyreece had been very unwell, so he could become unwell again quickly,

0:45:12 > 0:45:15so it's better to have the specialist team involved.

0:45:15 > 0:45:17KYREECE CRIES

0:45:17 > 0:45:18Ohhh...

0:45:18 > 0:45:20Are you OK, Kyreece?

0:45:20 > 0:45:24We carry a full Intensive Care in the back of the ambulance.

0:45:24 > 0:45:27If we have a clinical incident and the patient needs some kind

0:45:27 > 0:45:31of intervention or treatment, we have to stop and pull over.

0:45:31 > 0:45:35She promised she'd call if there was a problem, and my phone didn't ring

0:45:35 > 0:45:38and I'm sure if there was a problem she would have called me.

0:45:39 > 0:45:42It's sunny. Can you feel the sun?

0:45:42 > 0:45:45Yes, it's beautiful.

0:45:48 > 0:45:51That's us.

0:45:51 > 0:45:54We'll probably get round OK.

0:45:54 > 0:45:57I think it's really important that Kyreece has the same

0:45:57 > 0:46:01quality of life that any of us can expect.

0:46:01 > 0:46:04To do that we have to make sure that he doesn't become hospitalised

0:46:04 > 0:46:06or institutionalised.

0:46:06 > 0:46:10And places like Martin House are so important

0:46:10 > 0:46:14to just make things as normal as possible for Kyreece.

0:46:14 > 0:46:18Are we getting any more of your smiles?

0:46:18 > 0:46:21- Yeah.- Yes?- Have you got lots of big smiles for us at Martin House?

0:46:21 > 0:46:22- Yes!- Yes!

0:46:22 > 0:46:24Excellent.

0:46:24 > 0:46:27You've been so good, haven't you?

0:46:27 > 0:46:29Ready? Wheeee!

0:46:30 > 0:46:31Well done!

0:46:31 > 0:46:34- Is it a nice hotel? - That was a big smile.

0:46:34 > 0:46:37I think that helps, don't you?

0:46:37 > 0:46:39- MUM.- Kyreece is happy now, being there.

0:46:41 > 0:46:44When we first started going, it was a new place to him

0:46:44 > 0:46:47and it was the people, and in Martin House there is a lot of people.

0:46:49 > 0:46:54Go on the swings? You like the swings, don't you? Yeah?

0:46:54 > 0:46:57They are like family to you.

0:46:57 > 0:47:01Nothing is too much and they are happy and they are just

0:47:01 > 0:47:06so understanding, and that's what you need, somebody who understands.

0:47:08 > 0:47:10Whooo!

0:47:10 > 0:47:12After his sudden and life-threatening illness,

0:47:12 > 0:47:15Kyreece is starting to build up strength again.

0:47:15 > 0:47:17His mum is confident that in a few weeks' time

0:47:17 > 0:47:20he'll be well enough to go back to school.

0:47:20 > 0:47:21That's good, innit?

0:47:21 > 0:47:23Do you like it?

0:47:23 > 0:47:25Do you like it?

0:47:27 > 0:47:29Back at Embrace headquarters near Barnsley,

0:47:29 > 0:47:33and the search is on to find a spare cot for baby Jackson, who is

0:47:33 > 0:47:36being treated on the specialist neonatal unit in Sheffield.

0:47:39 > 0:47:41I just wondered if there's been any changes

0:47:41 > 0:47:45and whether or not we could send Jackson to you.

0:47:46 > 0:47:48After six. Right, OK.

0:47:48 > 0:47:52I'll pass that on to our coordinator and we'll see what they can do.

0:47:52 > 0:47:56At two days old, Jackson was having unexplained fits

0:47:56 > 0:47:58and breathing problems, so Embrace moved him

0:47:58 > 0:48:01from Barnsley Hospital to the Jessop Wing Hospital.

0:48:01 > 0:48:06Jackson was also showing signs that he might have brain damage,

0:48:06 > 0:48:09particularly the way he held his thumbs.

0:48:10 > 0:48:12He didn't move.

0:48:12 > 0:48:15He was quite lifeless and his thumbs were just tucked in.

0:48:15 > 0:48:18That was the main thing we noticed, really. And he just...

0:48:18 > 0:48:21We were asking if it was normal and none of them could give us

0:48:21 > 0:48:25an answer straightaway, but we noticed quite soon.

0:48:25 > 0:48:29Tests revealed that although, thankfully, he didn't have serious

0:48:29 > 0:48:34lasting neurological problems, baby Jackson did have meningitis.

0:48:34 > 0:48:37Fortunately it was a strain that could be treated

0:48:37 > 0:48:40with an intensive course of antibiotics.

0:48:40 > 0:48:44That word, meningitis, you think the worst straightaway.

0:48:44 > 0:48:46But they reassured us that it wasn't

0:48:46 > 0:48:50as bad with younger babies as it would be with a toddler.

0:48:50 > 0:48:54- DAD:- Every day we were going to Jessop's

0:48:54 > 0:48:56and he was on these antibiotics for two weeks

0:48:56 > 0:48:59and for the first few days he would pick up

0:48:59 > 0:49:03and then after about three or four days, he started...

0:49:03 > 0:49:05His hands started moving, didn't they? We were like,

0:49:05 > 0:49:09"Oh, look, his hands are moving!" He started coming on, didn't he?

0:49:10 > 0:49:14After two weeks, baby Jackson is well enough for the Embrace team

0:49:14 > 0:49:17to move him back to Barnsley Hospital.

0:49:17 > 0:49:19He looks quite chilled out, doesn't he?

0:49:21 > 0:49:25He's wriggling a little bit, but he looks all right.

0:49:26 > 0:49:29I had to make sure it doesn't upset my monitor, because

0:49:29 > 0:49:33if he kicks around a bit, it upsets my monitor and I don't like that.

0:49:33 > 0:49:36In the local hospital it's easier for Mum and Dad to visit

0:49:36 > 0:49:39and it also frees up a cot on the neonatal unit

0:49:39 > 0:49:43in Sheffield for a baby who is more acutely ill.

0:49:43 > 0:49:45From Barnsley.

0:49:46 > 0:49:48After three more weeks on the ward,

0:49:48 > 0:49:51Mum and Dad are finally able to bring Jackson home.

0:49:53 > 0:49:55He's watching! What are you watching?

0:49:56 > 0:49:59He's quite a funny, cheeky little baby.

0:49:59 > 0:50:03He laughs a lot he's always got to be awake and one eye open.

0:50:03 > 0:50:05JACKSON CRIES

0:50:05 > 0:50:07Oh, dear!

0:50:07 > 0:50:10Oh, no. He likes attention all the time.

0:50:10 > 0:50:13You've got to give him attention.

0:50:13 > 0:50:18But, yeah, he's a little monkey, isn't he? Cheeky.

0:50:18 > 0:50:22It's good to have him home, yeah. He's boss of the house.

0:50:24 > 0:50:27Yeah, it's nice to have him home

0:50:27 > 0:50:29and it's nice to be the parents,

0:50:29 > 0:50:30- isn't it?- Yeah.

0:50:30 > 0:50:32Doing things for him and looking after him.

0:50:32 > 0:50:36We had to have fertility medication to get pregnant,

0:50:36 > 0:50:40so we feel quite lucky that we've managed to...

0:50:40 > 0:50:43We've gone through it all, but he's come out.

0:50:43 > 0:50:46- We didn't think we'd have any, did we?- No.

0:50:46 > 0:50:49We never thought we'd be able to have any.

0:50:49 > 0:50:53We've come through it quite hard, but we are grateful for him now.

0:50:57 > 0:50:59Meanwhile, at Sheffield Children's Hospital,

0:50:59 > 0:51:03another Embrace patient, nine-year-old Katarina,

0:51:03 > 0:51:05is about to find out if her leukaemia has returned.

0:51:07 > 0:51:09She's been treated at this cancer unit

0:51:09 > 0:51:12since she was diagnosed in August 2012.

0:51:14 > 0:51:19When I was first diagnosed, Mum and Dad sat me down and said,

0:51:19 > 0:51:27"Do you know all those other little girls on the ward with no hair?"

0:51:29 > 0:51:34He said, "You're going to lose your hair." I said "Why?"

0:51:34 > 0:51:38And he said, "Because you've got ALL." I said, "what's that?"

0:51:38 > 0:51:44He said, "That's Acute Lympho...blastic Leukemia."

0:51:51 > 0:51:56- MUM:- From the day she was diagnosed, she has changed...a lot.

0:51:56 > 0:52:00Sometimes you to forget what they used to look like.

0:52:02 > 0:52:03I'll never feel what she felt.

0:52:04 > 0:52:08I'll probably never experience what she has experienced...

0:52:09 > 0:52:12..but it gets me to appreciate more

0:52:12 > 0:52:15that she's here and fighting and alive.

0:52:16 > 0:52:20- You're pulling stupid faces now. - No, I'm not.

0:52:21 > 0:52:23She wasn't responding to treatment.

0:52:23 > 0:52:28She had some new drugs which she has responded to,

0:52:28 > 0:52:32but then had complications with infection in the sinus and brain.

0:52:32 > 0:52:36And it took her a long time to recover from that.

0:52:36 > 0:52:42Subsequently, in February this year she was fit for a transplant

0:52:42 > 0:52:46and received an unrelated transplant.

0:52:46 > 0:52:49Katerina had her bone marrow transplant in February,

0:52:49 > 0:52:53and until last week she'd been in remission for five months.

0:52:53 > 0:52:56Then, on the first day of a family holiday in the North-East,

0:52:56 > 0:53:01she had a seizure, triggering fears that her leukaemia had come back.

0:53:03 > 0:53:06The Embrace team was mobilised and brought her to Sheffield

0:53:06 > 0:53:11from Newcastle, so the doctors who knew her best could carry out tests.

0:53:12 > 0:53:13It...

0:53:13 > 0:53:15It feels like you're dying,

0:53:15 > 0:53:18cos you struggle to breathe and you're like...

0:53:18 > 0:53:20SHE GASPS FOR BREATH

0:53:20 > 0:53:24I think what most parents who've been through this would probably say

0:53:24 > 0:53:28is that after a while it does actually become normal.

0:53:28 > 0:53:30You don't think that when it starts off.

0:53:30 > 0:53:33You think, "How on earth am I going to cope with this?"

0:53:33 > 0:53:37But actually, after a while, it becomes your way of life.

0:53:37 > 0:53:42So I've just had a word with the pathologist

0:53:42 > 0:53:47who looked at the biopsy that she had last Wednesday with a microscope,

0:53:47 > 0:53:51and that was the final result we were waiting for.

0:53:51 > 0:53:57And the good news is that they see no traces of either leukaemia

0:53:57 > 0:53:59or infection in the brain.

0:53:59 > 0:54:04What that means is that the fit that Katerina had a week ago

0:54:04 > 0:54:09were due to the high level of tacrolimus

0:54:09 > 0:54:13that they had documented in Newcastle.

0:54:13 > 0:54:17And with now reducing the dose

0:54:17 > 0:54:20and keeping her at the lower level,

0:54:20 > 0:54:23she shouldn't be at risk of having more fits.

0:54:23 > 0:54:25Fantastic. Thank you very much.

0:54:26 > 0:54:31The result on the brain, what they had to take for a biopsy,

0:54:31 > 0:54:34it's all negative.

0:54:34 > 0:54:38It's all good. We could go home tonight.

0:54:38 > 0:54:40No.

0:54:40 > 0:54:41SHE GIGGLES

0:54:42 > 0:54:49- Why not?- Now that I've been in a hospital, I like it here.

0:54:49 > 0:54:51I like it. I don't want to go home.

0:54:51 > 0:54:54It has a playroom and keeps you occupied.

0:54:54 > 0:55:00Whenever you finish work, I'll give you a shout to come and pick us up.

0:55:01 > 0:55:03Are you all right with all that?

0:55:04 > 0:55:08OK. All right, then. See you later. Love you, bye.

0:55:10 > 0:55:11We're going home!

0:55:11 > 0:55:13SHE LAUGHS

0:55:14 > 0:55:18We constantly check her, that she's OK,

0:55:18 > 0:55:24but seeing her, what she has gone through, you've just got to say

0:55:24 > 0:55:28to yourself to keep going, because you've got to keep going.

0:55:28 > 0:55:32She is strong, and seeing her smile after all...

0:55:33 > 0:55:36..the hurdles just keeps me going.

0:55:39 > 0:55:42But Katerina's reprieve was not to last.

0:55:42 > 0:55:45Although she'd managed to beat the leukaemia,

0:55:45 > 0:55:48her immune system had been badly damaged.

0:55:48 > 0:55:52A few weeks after we finished filming,

0:55:52 > 0:55:54another infection spread through her body.

0:55:56 > 0:55:59On November 30, 2013,

0:55:59 > 0:56:02Katerina died in Sheffield Children's Hospital

0:56:02 > 0:56:04with her family around her.

0:56:15 > 0:56:19At Leeds General Infirmary, 14-year-old Chance is about to visit

0:56:19 > 0:56:23the nurses who kept him alive before his heart transplant.

0:56:23 > 0:56:25The last time he was here,

0:56:25 > 0:56:28Chance was setting off on a life-changing journey

0:56:28 > 0:56:30to Great Ormond Street Hospital,

0:56:30 > 0:56:32with Embrace consultant Hazel and her team.

0:56:36 > 0:56:38The Embrace team was so good.

0:56:38 > 0:56:41The way they went about it, it was fantastic.

0:56:41 > 0:56:44But I just wanted that night to be over so quick.

0:56:44 > 0:56:49Dozens of people have been involved in Chance's remarkable recovery,

0:56:49 > 0:56:52but staff at the children's heart unit in Leeds looked after him

0:56:52 > 0:56:54for five months.

0:56:54 > 0:56:57- Hello, nice to see you. - Nice to see you. Hello, sweetheart.

0:56:57 > 0:57:01- Are you feeling good?- Yeah. - Looking fab.

0:57:01 > 0:57:04- I know, he looks brill.- He's doing really well.- Glad to have him home?

0:57:04 > 0:57:08- Oh, absolutely. Absolutely. - How long were you in altogether?

0:57:08 > 0:57:09About five...

0:57:09 > 0:57:12It's rare for Embrace medics to see their patients again,

0:57:12 > 0:57:15but Dr Hazel, who was key in getting Chance

0:57:15 > 0:57:19to his heart transplant in time, happens to be in the building.

0:57:19 > 0:57:22She takes the opportunity to check up on her former patient.

0:57:22 > 0:57:24Hello, Chance, do you remember me?

0:57:24 > 0:57:29Can you remember my name? I don't expect you to. It's Hazel.

0:57:29 > 0:57:32Wow, you look amazing.

0:57:32 > 0:57:34Wow.

0:57:34 > 0:57:36You look like you've grown a bit as well,

0:57:36 > 0:57:38but I've never seen you standing up properly either.

0:57:38 > 0:57:42- He has grown a bit, yeah. - Have you got a big appetite?- Yeah.

0:57:42 > 0:57:46- It was very scary, but... - Did you feel quite frightened?

0:57:46 > 0:57:51- Well, not the actual journey. - The journey was good.

0:57:51 > 0:57:53- That's what I like to hear.- Yeah.

0:57:53 > 0:57:58- Were you quite scared? It's all right to be afraid.- Yeah.- Yeah.

0:57:58 > 0:58:00What was the worst thing about the journey for you?

0:58:00 > 0:58:04- Was it the thought of getting there, or was it...?- Yeah.

0:58:04 > 0:58:09It just seemed to be so quick, do you know what I mean?

0:58:09 > 0:58:12One minute he's there, the next minute he's got the heart and...

0:58:12 > 0:58:14I think we are going to have to unblock the corridor

0:58:14 > 0:58:20and I'm going to have to get on my way. It's really nice to see you.

0:58:20 > 0:58:23- Thank you very much.- And I hope you never have to use Embrace ever again.

0:58:23 > 0:58:25LAUGHTER

0:58:25 > 0:58:29- Thank you.- Thank you.- It's all right, you're done, don't worry.

0:58:29 > 0:58:32- Thank you, bye.- See you, bye-bye.

0:58:32 > 0:58:33Bye.