Pennod 8

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0:00:21 > 0:00:26- The season has changed outside - Ysbyty Gwynedd's children ward.

0:00:26 > 0:00:28- It's cold and wet.

0:00:29 > 0:00:33- It's the ideal conditions - to catch a cold.

0:00:38 > 0:00:41- This is Erin Haf.

0:00:42 > 0:00:46- She has bronchiolitis. - We thought it was just a cold.

0:00:47 > 0:00:51- She was coughing. - We brought her in on Thursday.

0:00:52 > 0:00:57- She's been here ever since. - They're checking her oxygen levels.

0:00:57 > 0:01:00- She's on oxygen to help her breathe.

0:01:01 > 0:01:05- Erin is tiny. How old is she?

0:01:05 > 0:01:08- Four months.

0:01:09 > 0:01:11- Is this her first visit?

0:01:11 > 0:01:13- Is this her first visit?- - Yes, to hospital.

0:01:13 > 0:01:17- She has a twin brother.

0:01:18 > 0:01:22- He was in hospital - when he was nine days old.

0:01:23 > 0:01:25- He wasn't breathing properly.

0:01:26 > 0:01:29- He was on oxygen.

0:01:31 > 0:01:34- He has been coughing, too.

0:01:34 > 0:01:37- We hope he doesn't have to come in, - too.

0:01:38 > 0:01:41- He seems OK at the moment.

0:01:44 > 0:01:47- She has oxygen up her nose.

0:01:47 > 0:01:52- That helps her oxygen levels - and her breathing.

0:01:52 > 0:01:57- She was breathing heavily - and more fiercely than now.

0:01:58 > 0:02:01- She has a drip in her hand.

0:02:02 > 0:02:05- The tube in her nose feeds her.

0:02:06 > 0:02:11- She has a feed every hour - through the drip and her nose.

0:02:12 > 0:02:14- You look exhausted.

0:02:14 > 0:02:16- You look exhausted.- - I am.

0:02:17 > 0:02:19- How long has this been going on?

0:02:19 > 0:02:20- How long has this been going on?- - Over a week.

0:02:20 > 0:02:22- How are you managing?

0:02:22 > 0:02:24- How are you managing?- - Kim's mother is looking after them.

0:02:24 > 0:02:26- She's very good like that.

0:02:27 > 0:02:30- We pop over every now and then - to check on them.

0:02:30 > 0:02:32- We had tea there last night...

0:02:33 > 0:02:37- ..so we could spend time - with her brother and sister.

0:02:37 > 0:02:41- They're fine. The eldest has a cold.

0:02:41 > 0:02:44- The little one has a cough, too.

0:02:45 > 0:02:49- We give them Calpol and Ibuprofen...

0:02:52 > 0:02:55- ..and plenty of medication...

0:02:56 > 0:02:58- ..to help them.

0:03:01 > 0:03:03- Right, then. Are you OK?

0:03:08 > 0:03:10- My hands are cold.

0:03:14 > 0:03:16- It's OK.

0:03:16 > 0:03:19- My hands are too cold to touch her.

0:03:19 > 0:03:21- She's nice and warm.

0:03:21 > 0:03:23- Is this common in babies?

0:03:23 > 0:03:24- Is this common in babies?- - Yes.

0:03:25 > 0:03:29- From November to March, really...

0:03:30 > 0:03:34- ..we see a lot of babies, - up to one year of age.

0:03:34 > 0:03:37- They have bronchiliotis.

0:03:37 > 0:03:42- When adults cough...

0:03:42 > 0:03:45- ..we get rid of the secretions.

0:03:45 > 0:03:49- Unfortunately, - babies can't get rid of it.

0:03:50 > 0:03:53- They need the support of machines.

0:03:54 > 0:03:58- Erin is on the Bubble CPAP machine.

0:03:59 > 0:04:01- It's a new machine.

0:04:01 > 0:04:05- She's only the second patient - to use it this year.

0:04:05 > 0:04:08- It supports her breathing.

0:04:09 > 0:04:14- It delivers humidified oxygen, - oxygen that's warm.

0:04:16 > 0:04:20- That goes in her nose - and through her whole system.

0:04:20 > 0:04:22- Erin is much better.

0:04:23 > 0:04:25- She had to work hard earlier on.

0:04:25 > 0:04:29- We put her on this machine - to give her a rest.

0:04:31 > 0:04:33- We feed her through her nose.

0:04:34 > 0:04:38- Usually, it's orally, but - they can have it through the nose.

0:04:38 > 0:04:42- She can't feed.

0:04:42 > 0:04:46- That's why she gets it - through her nose.

0:04:46 > 0:04:51- She's much better. - Her breathing has greatly improved.

0:04:51 > 0:04:54- Mam and Dad are quite happy - with her progress.

0:04:55 > 0:04:58- She's doing really well. - We're chuffed.

0:04:58 > 0:05:03- How do you comfort anxious parents?

0:05:04 > 0:05:09- We tell them it isn't their fault. - A lot of parents blame themselves.

0:05:10 > 0:05:15- They worry they should have done - something sooner to prevent it.

0:05:15 > 0:05:18- But there's nothing - they could have done.

0:05:19 > 0:05:23- It's one of those things. We can't - help it when we catch a cold.

0:05:24 > 0:05:26- Babies need the support.

0:05:27 > 0:05:29- A lot of children get it.

0:05:30 > 0:05:34- She'll be fine and - will have the best possible care.

0:05:39 > 0:05:44- The ward is filling up with children - suffering from winter illnesses.

0:05:45 > 0:05:47- The nurses are used to it.

0:05:49 > 0:05:51- This is Sara.

0:05:52 > 0:05:55- She has been coughing all night.

0:05:56 > 0:05:58- She's had nebulizers.

0:06:00 > 0:06:02- Haven't you?

0:06:02 > 0:06:05- You've been brave.

0:06:06 > 0:06:10- She's on oxygen.

0:06:10 > 0:06:15- Her Sats are down. She's doing well.

0:06:15 > 0:06:18- She'll have an X-ray later.

0:06:19 > 0:06:22- What are the Sats down to?

0:06:22 > 0:06:26- They went down to 86 or 87.

0:06:27 > 0:06:33- She's had oxygen, nebulizers - and everyone is looking after her.

0:06:35 > 0:06:37- You've been brilliant.

0:06:37 > 0:06:40- Where did Dad sleep last night?

0:06:40 > 0:06:42- There.

0:06:43 > 0:06:45- Did he sleep at all?

0:06:46 > 0:06:48- A little.

0:06:48 > 0:06:51- Did you cough all night?

0:06:52 > 0:06:53- No.

0:06:54 > 0:06:58- Dad fell asleep in the chair.

0:06:59 > 0:07:01- Dad was here, wasn't he?

0:07:02 > 0:07:05- She's had a cold for a few days.

0:07:06 > 0:07:08- She's asthmatic, too.

0:07:08 > 0:07:13- At some point, if the cold worsens, - the cold takes over.

0:07:13 > 0:07:16- She can't breathe.

0:07:19 > 0:07:23- It's the same old story, - coming to Bangor to be looked after.

0:07:24 > 0:07:28- She's had more steroids - and nebulizers.

0:07:28 > 0:07:32- We didn't need anything - intravenously yet, thank goodness.

0:07:34 > 0:07:37- That's a relief.

0:07:40 > 0:07:43- You sound like you're an old hand.

0:07:44 > 0:07:50- This is my fortieth or fiftieth - time here.

0:07:51 > 0:07:53- It's something like that.

0:07:53 > 0:07:57- We take it in our stride.

0:07:57 > 0:08:01- We know all the criteria - with the asthma.

0:08:04 > 0:08:08- In a couple of days, - we'll be back home.

0:08:09 > 0:08:11- Won't we, babes?

0:08:12 > 0:08:14- I want to play.

0:08:14 > 0:08:18- Anti Steph has to go home - to her children.

0:08:20 > 0:08:22- I'll see you soon.

0:08:23 > 0:08:25- High five. Good girl.

0:08:25 > 0:08:26- Say thank you.

0:08:26 > 0:08:27- Say thank you.- - Thank you.

0:08:27 > 0:08:31- I'll see you again. - You've been brilliant.

0:08:31 > 0:08:32- OK?

0:08:32 > 0:08:36- Will you bring me a sticker?

0:08:36 > 0:08:38- Yes.

0:08:39 > 0:08:43- I'll find one for you. - You've been a brilliant girl.

0:08:44 > 0:08:48- Well done. I'll get a sticker.

0:08:49 > 0:08:51- OK? Love her!

0:08:59 > 0:09:02- The doctors have assessed Erin.

0:09:05 > 0:09:08- Hold it.

0:09:10 > 0:09:14- The doctors think she's well enough - to go on Optiflow.

0:09:15 > 0:09:17- CPAP supplies air pressure.

0:09:17 > 0:09:22- She doesn't need the pressure now, - only humidified oxygen.

0:09:23 > 0:09:26- The machine gives her - the humidified oxygen.

0:09:27 > 0:09:29- We'll put this on her now.

0:09:30 > 0:09:33- She won't like this. - She's settled down a bit.

0:09:33 > 0:09:37- We're adjusting her so - Mam and Dad can see her pretty face.

0:09:37 > 0:09:40- She's headed towards - the right direction.

0:09:41 > 0:09:46- Mam and Dad popped out. - It isn't nice for them to see this.

0:09:48 > 0:09:53- The doctors are happy. We've stopped - the fluids and giving her more feed.

0:09:54 > 0:09:55- That's a really good sign.

0:09:56 > 0:10:00- I'll move it to the side - just so you can get to her.

0:10:08 > 0:10:12- No allergies?

0:10:12 > 0:10:13- No.

0:10:13 > 0:10:14- No.- - Lovely.

0:10:16 > 0:10:17- She's sleeping.

0:10:19 > 0:10:21- I'll just lift you a little.

0:10:26 > 0:10:27- Alright, babes?

0:10:27 > 0:10:29- I know.

0:10:32 > 0:10:35- We'll give you the steamy one again.

0:10:35 > 0:10:37- There you are.

0:10:41 > 0:10:44- You can have the steamy one again.

0:10:44 > 0:10:46- MACHINE BLEEPS

0:11:00 > 0:11:04- I'll put this on. - There you are, love.

0:11:05 > 0:11:09- Keep that there for a while.

0:11:12 > 0:11:18- Sara has been here since last night - with difficulty breathing.

0:11:18 > 0:11:20- She has any temperature?

0:11:20 > 0:11:22- She's had a temperature.

0:11:22 > 0:11:24- We'll look at the numbers.

0:11:25 > 0:11:26- She had a 30.9?

0:11:26 > 0:11:28- She had a 30.9?- - 37.9, yes.

0:11:30 > 0:11:34- Her numbers are looking - as if she's got fast breathing.

0:11:34 > 0:11:36- Her heart rate is a bit fast.

0:11:38 > 0:11:41- We had a look at her X-ray - and it looks fine.

0:11:41 > 0:11:44- There's no evidence - of any infection.

0:11:44 > 0:11:49- It's probably a viral illness, - that's why she has a temperature.

0:11:49 > 0:11:51- That's triggered her asthma.

0:11:51 > 0:11:55- We need to keep on top - of the nebulizer medications.

0:11:55 > 0:11:59- She will probably require it - more often in the next few hours.

0:12:00 > 0:12:03- We might have to give - another injection...

0:12:04 > 0:12:08- ..before the magnesium sulphate - through the drip...

0:12:08 > 0:12:12- ..if she doesn't improve - with these medications.

0:12:12 > 0:12:16- We'll come back and listen - to her chest and make a plan...

0:12:17 > 0:12:19- ..to see where we are going.

0:12:20 > 0:12:21- Any questions?

0:12:21 > 0:12:24- Any questions?- - No. You've answered most of them.

0:12:24 > 0:12:26- Thank you.

0:12:27 > 0:12:29- What do you think about that?

0:12:29 > 0:12:31- What do you think about that?- - The usual story.

0:12:32 > 0:12:37- It depends on the outcome - of changing the medication.

0:12:37 > 0:12:41- Most of the time, - it doesn't make much difference.

0:12:41 > 0:12:46- Some of the things they try - make a big difference.

0:12:47 > 0:12:52- They sent her home with Montelukast - last time.

0:12:53 > 0:12:57- They do improve things...

0:12:58 > 0:13:01- ..but not that much.

0:13:01 > 0:13:07- The cold causes the asthma attacks.

0:13:10 > 0:13:12- We'll see if she can get over it.

0:13:12 > 0:13:15- Has she been this poorly before?

0:13:15 > 0:13:18- Yes, much worse than this.

0:13:19 > 0:13:23- When she was three...

0:13:23 > 0:13:27- ..she had a really bad asthma - attack.

0:13:27 > 0:13:29- It turned into pneumonia.

0:13:30 > 0:13:34- We were here for a fortnight...

0:13:35 > 0:13:38- ..trying to make her better.

0:13:39 > 0:13:43- This attack isn't the worst by far.

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0:13:59 > 0:13:59- Subtitles

0:13:59 > 0:14:01- Subtitles- - Subtitles

0:14:08 > 0:14:13- Sara's condition has worsened - since arriving last night.

0:14:13 > 0:14:17- Her temperature has risen - and she has breathing difficulties.

0:14:18 > 0:14:22- How much is she having? 40? Oh yes.

0:14:22 > 0:14:26- If I give her her Neb first - and a paracetamol...

0:14:26 > 0:14:30- ..and then her Pred - when she feels a bit better.

0:14:32 > 0:14:35- Sara is having her third nebulizer.

0:14:36 > 0:14:39- Then the doctors will review her.

0:14:40 > 0:14:43- She feels a bit rubbish.

0:14:43 > 0:14:48- She has a temperature, too. - We'll give her some paracetamol.

0:14:48 > 0:14:51- That should make her feel better.

0:15:01 > 0:15:02- Paracetamol.

0:15:07 > 0:15:09- Sara.

0:15:09 > 0:15:14- Sara, love. - Here's some paracetamol and Calpol.

0:15:14 > 0:15:17- Will you take it for me - to make you better?

0:15:17 > 0:15:21- Just a little, OK? - Then you can go back to sleep.

0:15:21 > 0:15:24- We don't need this for a minute.

0:15:25 > 0:15:27- There you are.

0:15:27 > 0:15:30- Do you want to do it, or shall I?

0:15:31 > 0:15:34- Can I have a spoon?

0:15:34 > 0:15:37- I'll get a spoon.

0:15:39 > 0:15:41- Drink first?

0:15:42 > 0:15:44- More?

0:15:52 > 0:15:56- I only want ice-cream.

0:15:56 > 0:15:59- There you are. Drink it all quickly. - Open wide.

0:16:02 > 0:16:05- I'll get you a drink.

0:16:05 > 0:16:07- This will make you feel better.

0:16:08 > 0:16:11- Take the medication now.

0:16:11 > 0:16:13- Open wide.

0:16:14 > 0:16:18- It'll make you feel much better - then you can have your ice-cream.

0:16:20 > 0:16:23- Sara is very independent!

0:16:23 > 0:16:27- She knows exactly what she wants. - It's hard to get round her.

0:16:27 > 0:16:31- She'll take it when - she's ready and really needs it.

0:16:34 > 0:16:36- Erin is a big girl.

0:16:37 > 0:16:40- She stayed in hospital on her own.

0:16:41 > 0:16:44- Mam and Dad went home for a break.

0:16:44 > 0:16:49- They need to chill. - They've been here for days.

0:16:49 > 0:16:52- They need to sleep and relax.

0:16:53 > 0:16:56- They didn't like the idea - of leaving her...

0:16:57 > 0:17:02- ..but it's important they - have the energy to be here for her.

0:17:03 > 0:17:07- She's much better, so they were - happy to leave her for a little bit.

0:17:08 > 0:17:11- But they miss you a lot.

0:17:13 > 0:17:15- It's nice when they get better.

0:17:16 > 0:17:20- She's not quite there yet, - but she's much better.

0:17:22 > 0:17:25- We feed her through the NG tube...

0:17:26 > 0:17:30- ..while she doesn't have the energy - to feed herself.

0:17:30 > 0:17:35- She'll take food orally soon, - because she's much better.

0:17:38 > 0:17:41- You'll have food - in quarter of an hour.

0:17:47 > 0:17:50- The doctors are worried about Sara.

0:17:51 > 0:17:56- They've moved her to a room - that's closer to the nurses.

0:17:56 > 0:17:58- There you are.

0:18:00 > 0:18:03- We've moved off the ward - to this cubicle.

0:18:04 > 0:18:10- Her asthma isn't responding - to the medicine.

0:18:10 > 0:18:15- They're going - to try IV medication...

0:18:16 > 0:18:21- ..to see if that will - speed up her recovery.

0:18:22 > 0:18:24- There you are.

0:18:25 > 0:18:27- We're tangled!

0:18:29 > 0:18:31- Have you got wipes?

0:18:31 > 0:18:33- I'll get you one.

0:18:33 > 0:18:35- I'll get you one.- - Dad has some.

0:18:36 > 0:18:39- Do you want to move to the middle?

0:18:43 > 0:18:45- Do you want a blanket?

0:18:45 > 0:18:51- That's every hour. We'll review her - after the blood results come back.

0:18:51 > 0:18:54- OK, Sara?

0:19:02 > 0:19:06- Erin's parents are back, - ready for the nightshift.

0:19:08 > 0:19:11- I have to test the tube first...

0:19:11 > 0:19:16- ..to check it's in her nose - and still at 24cms.

0:19:17 > 0:19:22- I test it by aspirating - the stomach contents.

0:19:23 > 0:19:27- I'm checking it's still - in her stomach and hasn't moved.

0:19:30 > 0:19:34- She's sleeping soundly. - It's a shame to disturb her.

0:19:37 > 0:19:41- We use pH sticks - and measure them against these.

0:19:42 > 0:19:44- I'll show you now.

0:19:47 > 0:19:49- It needs to be five or less.

0:19:50 > 0:19:54- It's now 5.5 - so I need more aspirate.

0:19:55 > 0:19:58- She gets this feed - every hour through her nose.

0:19:59 > 0:20:01- We test it every time we do it.

0:20:06 > 0:20:08- That's better.

0:20:09 > 0:20:12- That's a better stomach sample.

0:20:13 > 0:20:16- That's 4.5.

0:20:16 > 0:20:19- I'm happy to carry on with the feed.

0:20:21 > 0:20:23- Right, then.

0:20:29 > 0:20:30- That's it.

0:20:32 > 0:20:34- We let gravity do the work.

0:20:36 > 0:20:38- It's really slow.

0:20:38 > 0:20:42- We don't push it, we start it off.

0:20:43 > 0:20:45- It goes down quite quickly.

0:20:45 > 0:20:49- She has so little volume - there's no need for Gaviscon.

0:20:50 > 0:20:54- It goes quite fast. - It's only a small amount of volume.

0:20:54 > 0:20:58- She isn't on a full feed. - It gives her the break she needs.

0:20:59 > 0:21:05- We'll increase the volume gradually, - then she can have a bottle.

0:21:05 > 0:21:09- That's good. - By tomorrow, cross fingers.

0:21:13 > 0:21:16- Erin's parents will stay - another night in hospital.

0:21:18 > 0:21:21- Because only one parent - can sleep at the bedside...

0:21:22 > 0:21:26- ..Dad goes to Ty Enfys, - round the corner in Dewi Ward.

0:21:32 > 0:21:34- There are bedrooms here...

0:21:34 > 0:21:38- ..that are free to parents - who live too far to go home...

0:21:39 > 0:21:43- ..or who need to be in hospital - for long stretches.

0:21:43 > 0:21:48- This is Aaron's fifth night - in Ysbyty Gwynedd.

0:21:49 > 0:21:52- I'm in room 5.

0:21:53 > 0:21:56- It's quite nice here, actually.

0:21:57 > 0:22:01- There are two single beds - and a telly with Freeview.

0:22:02 > 0:22:05- There's a shower through there, - which is handy...

0:22:06 > 0:22:08- ..to save me having to go home.

0:22:09 > 0:22:12- It's quite nice here.

0:22:13 > 0:22:17- Everything is new.

0:22:20 > 0:22:22- Only one adult can stay in the ward.

0:22:23 > 0:22:25- My partner doesn't drive.

0:22:25 > 0:22:27- She can't pop out.

0:22:28 > 0:22:32- It's handy for us both to be here - to support each other.

0:22:33 > 0:22:36- I can pop out - to get anything she needs.

0:22:36 > 0:22:39- Because we're both here...

0:22:39 > 0:22:43- ..it saves us having to take shifts.

0:23:11 > 0:23:15- Sara is still going - back and forth to hospital...

0:23:15 > 0:23:17- ..but is looking forward to summer.

0:23:18 > 0:23:21- Erin returned once to hospital...

0:23:21 > 0:23:24- ..but she's much better now.

0:23:41 > 0:23:43- S4C Subtitles by Gwead

0:23:43 > 0:23:43- .