Pennod 8 Ward Plant


Pennod 8

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-The season has changed outside

-Ysbyty Gwynedd's children ward.

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-It's cold and wet.

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-It's the ideal conditions

-to catch a cold.

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-This is Erin Haf.

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-She has bronchiolitis.

-We thought it was just a cold.

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-She was coughing.

-We brought her in on Thursday.

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-She's been here ever since.

-They're checking her oxygen levels.

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-She's on oxygen to help her breathe.

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-Erin is tiny. How old is she?

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-Four months.

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-Is this her first visit?

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-Is this her first visit?

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-Yes, to hospital.

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-She has a twin brother.

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-He was in hospital

-when he was nine days old.

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-He wasn't breathing properly.

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-He was on oxygen.

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-He has been coughing, too.

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-We hope he doesn't have to come in,

-too.

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-He seems OK at the moment.

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-She has oxygen up her nose.

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-That helps her oxygen levels

-and her breathing.

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-She was breathing heavily

-and more fiercely than now.

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-She has a drip in her hand.

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-The tube in her nose feeds her.

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-She has a feed every hour

-through the drip and her nose.

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-You look exhausted.

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-You look exhausted.

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-I am.

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-How long has this been going on?

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-How long has this been going on?

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-Over a week.

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-How are you managing?

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-How are you managing?

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-Kim's mother is looking after them.

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-She's very good like that.

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-We pop over every now and then

-to check on them.

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-We had tea there last night...

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-..so we could spend time

-with her brother and sister.

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-They're fine. The eldest has a cold.

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-The little one has a cough, too.

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-We give them Calpol and Ibuprofen...

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-..and plenty of medication...

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-..to help them.

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-Right, then. Are you OK?

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-My hands are cold.

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-It's OK.

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-My hands are too cold to touch her.

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-She's nice and warm.

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-Is this common in babies?

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-Is this common in babies?

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-Yes.

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-From November to March, really...

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-..we see a lot of babies,

-up to one year of age.

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-They have bronchiliotis.

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-When adults cough...

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-..we get rid of the secretions.

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-Unfortunately,

-babies can't get rid of it.

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-They need the support of machines.

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-Erin is on the Bubble CPAP machine.

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-It's a new machine.

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-She's only the second patient

-to use it this year.

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-It supports her breathing.

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-It delivers humidified oxygen,

-oxygen that's warm.

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-That goes in her nose

-and through her whole system.

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-Erin is much better.

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-She had to work hard earlier on.

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-We put her on this machine

-to give her a rest.

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-We feed her through her nose.

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-Usually, it's orally, but

-they can have it through the nose.

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-She can't feed.

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-That's why she gets it

-through her nose.

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-She's much better.

-Her breathing has greatly improved.

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-Mam and Dad are quite happy

-with her progress.

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-She's doing really well.

-We're chuffed.

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-How do you comfort anxious parents?

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-We tell them it isn't their fault.

-A lot of parents blame themselves.

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-They worry they should have done

-something sooner to prevent it.

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-But there's nothing

-they could have done.

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-It's one of those things. We can't

-help it when we catch a cold.

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-Babies need the support.

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-A lot of children get it.

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-She'll be fine and

-will have the best possible care.

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-The ward is filling up with children

-suffering from winter illnesses.

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-The nurses are used to it.

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-This is Sara.

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-She has been coughing all night.

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-She's had nebulizers.

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-Haven't you?

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-You've been brave.

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-She's on oxygen.

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-Her Sats are down. She's doing well.

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-She'll have an X-ray later.

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-What are the Sats down to?

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-They went down to 86 or 87.

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-She's had oxygen, nebulizers

-and everyone is looking after her.

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-You've been brilliant.

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-Where did Dad sleep last night?

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-There.

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-Did he sleep at all?

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-A little.

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-Did you cough all night?

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-No.

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-Dad fell asleep in the chair.

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-Dad was here, wasn't he?

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-She's had a cold for a few days.

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-She's asthmatic, too.

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-At some point, if the cold worsens,

-the cold takes over.

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-She can't breathe.

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-It's the same old story,

-coming to Bangor to be looked after.

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-She's had more steroids

-and nebulizers.

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-We didn't need anything

-intravenously yet, thank goodness.

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-That's a relief.

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-You sound like you're an old hand.

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-This is my fortieth or fiftieth

-time here.

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-It's something like that.

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-We take it in our stride.

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-We know all the criteria

-with the asthma.

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-In a couple of days,

-we'll be back home.

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-Won't we, babes?

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-I want to play.

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-Anti Steph has to go home

-to her children.

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-I'll see you soon.

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-High five. Good girl.

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-Say thank you.

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-Say thank you.

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-Thank you.

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-I'll see you again.

-You've been brilliant.

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-OK?

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-Will you bring me a sticker?

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-Yes.

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-I'll find one for you.

-You've been a brilliant girl.

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-Well done. I'll get a sticker.

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-OK? Love her!

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-The doctors have assessed Erin.

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-Hold it.

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-The doctors think she's well enough

-to go on Optiflow.

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-CPAP supplies air pressure.

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-She doesn't need the pressure now,

-only humidified oxygen.

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-The machine gives her

-the humidified oxygen.

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-We'll put this on her now.

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-She won't like this.

-She's settled down a bit.

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-We're adjusting her so

-Mam and Dad can see her pretty face.

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-She's headed towards

-the right direction.

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-Mam and Dad popped out.

-It isn't nice for them to see this.

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-The doctors are happy. We've stopped

-the fluids and giving her more feed.

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-That's a really good sign.

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-I'll move it to the side

-just so you can get to her.

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-No allergies?

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-No.

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-No.

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-Lovely.

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-She's sleeping.

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-I'll just lift you a little.

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-Alright, babes?

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-I know.

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-We'll give you the steamy one again.

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-There you are.

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-You can have the steamy one again.

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-MACHINE BLEEPS

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-I'll put this on.

-There you are, love.

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-Keep that there for a while.

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-Sara has been here since last night

-with difficulty breathing.

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-She has any temperature?

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-She's had a temperature.

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-We'll look at the numbers.

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-She had a 30.9?

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-She had a 30.9?

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-37.9, yes.

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-Her numbers are looking

-as if she's got fast breathing.

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-Her heart rate is a bit fast.

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-We had a look at her X-ray

-and it looks fine.

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-There's no evidence

-of any infection.

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-It's probably a viral illness,

-that's why she has a temperature.

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-That's triggered her asthma.

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-We need to keep on top

-of the nebulizer medications.

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-She will probably require it

-more often in the next few hours.

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-We might have to give

-another injection...

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-..before the magnesium sulphate

-through the drip...

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-..if she doesn't improve

-with these medications.

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-We'll come back and listen

-to her chest and make a plan...

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-..to see where we are going.

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-Any questions?

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-Any questions?

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-No. You've answered most of them.

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-Thank you.

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-What do you think about that?

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-What do you think about that?

-

-The usual story.

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-It depends on the outcome

-of changing the medication.

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-Most of the time,

-it doesn't make much difference.

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-Some of the things they try

-make a big difference.

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-They sent her home with Montelukast

-last time.

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-They do improve things...

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-..but not that much.

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-The cold causes the asthma attacks.

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-We'll see if she can get over it.

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-Has she been this poorly before?

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-Yes, much worse than this.

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-When she was three...

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-..she had a really bad asthma

-attack.

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-It turned into pneumonia.

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-We were here for a fortnight...

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-..trying to make her better.

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-This attack isn't the worst by far.

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-Sara's condition has worsened

-since arriving last night.

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-Her temperature has risen

-and she has breathing difficulties.

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-How much is she having? 40? Oh yes.

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-If I give her her Neb first

-and a paracetamol...

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-..and then her Pred

-when she feels a bit better.

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-Sara is having her third nebulizer.

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-Then the doctors will review her.

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-She feels a bit rubbish.

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-She has a temperature, too.

-We'll give her some paracetamol.

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-That should make her feel better.

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-Paracetamol.

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-Sara.

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-Sara, love.

-Here's some paracetamol and Calpol.

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-Will you take it for me

-to make you better?

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-Just a little, OK?

-Then you can go back to sleep.

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-We don't need this for a minute.

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-There you are.

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-Do you want to do it, or shall I?

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-Can I have a spoon?

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-I'll get a spoon.

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-Drink first?

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-More?

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-I only want ice-cream.

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-There you are. Drink it all quickly.

-Open wide.

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-I'll get you a drink.

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-This will make you feel better.

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-Take the medication now.

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-Open wide.

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-It'll make you feel much better

-then you can have your ice-cream.

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-Sara is very independent!

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-She knows exactly what she wants.

-It's hard to get round her.

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-She'll take it when

-she's ready and really needs it.

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-Erin is a big girl.

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-She stayed in hospital on her own.

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-Mam and Dad went home for a break.

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-They need to chill.

-They've been here for days.

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-They need to sleep and relax.

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-They didn't like the idea

-of leaving her...

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-..but it's important they

-have the energy to be here for her.

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-She's much better, so they were

-happy to leave her for a little bit.

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-But they miss you a lot.

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-It's nice when they get better.

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-She's not quite there yet,

-but she's much better.

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-We feed her through the NG tube...

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-..while she doesn't have the energy

-to feed herself.

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-She'll take food orally soon,

-because she's much better.

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-You'll have food

-in quarter of an hour.

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-The doctors are worried about Sara.

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-They've moved her to a room

-that's closer to the nurses.

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-There you are.

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-We've moved off the ward

-to this cubicle.

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-Her asthma isn't responding

-to the medicine.

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-They're going

-to try IV medication...

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-..to see if that will

-speed up her recovery.

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-There you are.

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-We're tangled!

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-Have you got wipes?

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-I'll get you one.

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-I'll get you one.

-

-Dad has some.

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-Do you want to move to the middle?

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-Do you want a blanket?

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-That's every hour. We'll review her

-after the blood results come back.

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-OK, Sara?

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-Erin's parents are back,

-ready for the nightshift.

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-I have to test the tube first...

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-..to check it's in her nose

-and still at 24cms.

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-I test it by aspirating

-the stomach contents.

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-I'm checking it's still

-in her stomach and hasn't moved.

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-She's sleeping soundly.

-It's a shame to disturb her.

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-We use pH sticks

-and measure them against these.

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-I'll show you now.

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-It needs to be five or less.

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-It's now 5.5

-so I need more aspirate.

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-She gets this feed

-every hour through her nose.

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-We test it every time we do it.

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-That's better.

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-That's a better stomach sample.

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-That's 4.5.

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-I'm happy to carry on with the feed.

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-Right, then.

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-That's it.

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-We let gravity do the work.

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-It's really slow.

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-We don't push it, we start it off.

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-It goes down quite quickly.

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-She has so little volume

-there's no need for Gaviscon.

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-It goes quite fast.

-It's only a small amount of volume.

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-She isn't on a full feed.

-It gives her the break she needs.

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-We'll increase the volume gradually,

-then she can have a bottle.

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-That's good.

-By tomorrow, cross fingers.

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-Erin's parents will stay

-another night in hospital.

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-Because only one parent

-can sleep at the bedside...

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-..Dad goes to Ty Enfys,

-round the corner in Dewi Ward.

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-There are bedrooms here...

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-..that are free to parents

-who live too far to go home...

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-..or who need to be in hospital

-for long stretches.

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-This is Aaron's fifth night

-in Ysbyty Gwynedd.

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-I'm in room 5.

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-It's quite nice here, actually.

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-There are two single beds

-and a telly with Freeview.

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-There's a shower through there,

-which is handy...

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-..to save me having to go home.

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-It's quite nice here.

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-Everything is new.

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-Only one adult can stay in the ward.

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-My partner doesn't drive.

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-She can't pop out.

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-It's handy for us both to be here

-to support each other.

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-I can pop out

-to get anything she needs.

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-Because we're both here...

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-..it saves us having to take shifts.

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-Sara is still going

-back and forth to hospital...

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-..but is looking forward to summer.

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-Erin returned once to hospital...

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-..but she's much better now.

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