Pennod 2 Ysbyty


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Pennod 2

Pobl bwysig y boileri, peryglon y peiriant sganio, llawdriniaeth pen-glin a bywyd bregus yr uned gofal arbennig i fabanod. The lives of staff and patients at Ysbyty Gwynedd, Ban...


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-Bangor's Ysbyty Gwynedd

-is a busy yet homely place.

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-Its 530 beds and 3,500 staff...

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-..serve the people

-of North West Wales.

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-Every aspect of life is seen here.

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-Excitement at the Accident Unit,

-joy at the Maternity Unit.

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-They treat sick children

-and care for the elderly.

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-Operations, deaths and births...

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-..cleaners, chefs,

-maintenance workers...

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-..and laughter.

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-This and more in Ysbyty Gwynedd.

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-The Special Care Baby Unit treats

-the youngest, most fragile patients.

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-This Unit

-cares for tiny newborn babies.

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-The consultant does a formal ward

-round on Tuesdays and Thursdays.

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-The rest of the time,

-a doctor does the round.

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-It's a Tuesday morning,

-so here I am.

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-Usually, the babies are premature.

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-Premature babies get problems

-with their lungs and stomachs.

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-They're unable to digest food

-like a normal baby.

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-We slowly sift through the problems

-we'd expect from a premature baby.

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-We try to anticipate the problems.

-He hasn't had caffeine yet?

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-He isn't breathing much,

-except for ventilation breaths.

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-He's awake,

-but he seems comfortable.

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-Just lying there!

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-We're fairly busy.

-A baby was born last night.

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-I'll tell

-his mother how he's doing...

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-..and explain what

-we hope to do today and tomorrow.

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-He was ten weeks early.

-He's not meant to be here yet.

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-We'll see what his mother will say.

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-Terrence Channing from Holyhead

-is having an MRI scan.

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-He has throat cancer.

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-We're scanning his throat.

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-He's had a diagnosis from a biopsy.

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-The doctors will study the scan...

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-..and decide on treatment.

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-It'll be difficult for the patient

-because he can't lie flat.

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-He can't swallow

-or breathe properly.

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-We need to take care.

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-How are you doing?

-Have a cough and then swallow.

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-We'll start again when you're ready.

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-We'll start again when you're ready.

-

-PATIENT COUGHS

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-It can be a terrifying experience.

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-They don't understand the situation.

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-Once they see the scanner

-and talk to the staff...

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-..they accept it has to be done,

-for their own good.

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-This is the sound the patient hears.

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-LOUD TONE

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-They have headphones

-to listen to the radio.

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-They can bring their own CD

-and we play that for them.

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-It's a horrible sound.

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-OK, how are you feeling now?

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-OK.

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-You're struggling a bit, are you?

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-You're struggling a bit, are you?

-

-Yeah, just a bit.

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-Can I do anything to help?

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-Can I do anything to help?

-

-No, there's nothing you can do.

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-OK. Are you ready to start again?

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-OK. Are you ready to start again?

-

-OK.

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-All set for today?

-Which knee are we doing?

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-Rheinallt Jones

-is having a new knee.

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-It's the second

-he's received in Ysbyty Gwynedd.

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-You had the MRI scan

-a few weeks ago.

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-I'm looking forward

-to having it done.

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-I had the same surgery

-on the other leg eight years ago.

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-I've been through it.

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-They are made to measure.

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-I hope they get the right joint.

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-I wouldn't want to get

-somebody else's knee!

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-Rheinallt Jones

-is Mr Muthu Ganapathi's patient.

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-He uses the latest technology

-for the task.

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-I've used computer guided surgery

-for almost four years.

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-It's more precise

-than manual instrumentation.

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-But it takes longer.

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-We get an MRI scan of the patient's

-hip, knee and ankle.

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-That goes through a software and

-I get a 3D model made of his knee.

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-I plan the whole

-knee replacement in the computer.

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-I do a virtual replacement,

-planning the cuts...

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-..what size prosthesis

-I need to use.

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-It makes surgery much, much easier.

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-My surgical time is reduced by half.

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-Generally it takes about

-one hour, 20 minutes.

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-But now I'm doing the majority

-of the surgery in 35-45 minutes.

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-In the Baby Unit, it's a busy

-but enjoyable day for Dr Mair Parry.

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-The birth of a child is the best day

-of most people's lives.

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-I've shared that day with hundreds

-of families, which is lovely.

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-It's an honour and privilege.

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-But sadly, I wouldn't be

-there if everything was OK.

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-But I do enjoy it.

-I like seeing the little babies.

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-Shall we give him a fluid bolus?

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-We need to try to get the rate down

-and maybe reduce the morphine.

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-We'll try to reduce the rate.

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-OK, happy?

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-The nurses specialize

-in premature babies.

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-They tend to just work here.

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-Looking after a premature baby...

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-..is unlike

-caring for a 10-year-old.

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-They are specialist nurses.

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-The middle room is like

-an Intensive Care unit for babies.

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-They need different skills.

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-It's quite technical

-and more than just feeding babies.

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-A new patient arrives for a scan.

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-Are you OK?

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-Are you comfortable?

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-We're doing the head and throat.

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-They've found something.

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-The X-ray was inconclusive

-so they sent him for an MRI scan.

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-It provides

-a clearer view of the throat.

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-He's a broad man.

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-They usually find

-it more difficult to go in...

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-..because of the scanner's size,

-so it's not always the weight.

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-It's more difficult

-when patients are short and broad.

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-We like people

-who are tall and thin!

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-But a scan can be dangerous.

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-The scanner is a big magnet,

-so metal is prohibited.

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-The most serious problem

-is pacemakers.

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-We change the patients here

-and ensure their pockets are empty.

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-A patient insisted

-on wearing his own dressing gown.

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-I could see a metal object

-in his pocket.

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-He denied there was anything

-in his pocket.

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-There was a nail in his pocket.

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-The technology is amazing.

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-We get brilliant images.

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-It's great to know that these images

-are helping the patients.

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-Rheinallt Jones

-is under the anaesthetic.

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-He's ready

-for his knee replacement surgery.

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-The surgery is performed

-300 times a year in Ysbyty Gwynedd.

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-The continuously

-evolving techniques...

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-..shorten the recovery period.

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-Most patients walk the same

-day they've had a knee replacement.

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-Some even go home that day.

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-OK, starting!

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-Rheinallt Jones's new knee

-was designed for him on a computer.

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-The surgery itself

-takes less time...

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-..the surgeon's work is easier

-and it makes better use of his time.

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-The new pieces fit perfectly

-without having to reshape.

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-The treatment, designed beforehand,

-will save time under the knife.

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-Now we can see

-that it's fitting the bone.

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-The holes are made already.

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-I just need

-to make some holes and do the cuts.

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-The leg is almost ready

-for the new knee.

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-Incredibly, Rheinallt Jones

-will be on his feet...

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-..and walking in a few hours.

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-In part two,

-will the new knee impress?

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-A race to find a bed for this baby.

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-And rather unusual training.

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-And rather unusual training.

-

-Gary! It's time to wake up!

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-In the boiler room,

-a machine gets an annual service.

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-Alright?

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-It's a yearly on the boiler.

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-We open it up...

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-..clean out the tubes,

-test the gas...

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-..test the gas pressure...

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-..and we'll reassemble it...

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-..to make sure it's burning

-properly, that the CO is correct.

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-These boilers heat the water...

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-..and power the central heating.

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-The water

-goes through heat exchangers...

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-..which provide domestic hot water

-for baths and sinks.

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-We also send steam to the kitchen

-for the hospital's food.

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-The hospital couldn't carry on

-without this place.

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-They'd freeze in the winter

-and roast in the summer!

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-Everything here

-has to be in working order.

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-It doesn't matter if a bulb fuses,

-there are half a dozen of them.

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-But if one of these boilers go,

-they'd soon run out of hot water.

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-Very few people know what

-happens in here. They've no idea!

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-We're sweated buckets

-in here over the years.

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-Things are hotting up

-in the theatre, too.

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-Surgeons prepare to put the new

-knee in Rheinallt Jones's leg.

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-A special cement is used on the

-bone to hold the new piece in place.

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-It's a perfect fit, but

-it'll take an effort to position it.

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-Stop.

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-Make the knot, please.

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-It's good.

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-You can see the knee

-is straight and it moves nicely.

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-The kneecap is tracking,

-and that's one of the problems.

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-It's precise.

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-It's balanced nicely.

-I'm just going to close it now.

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-Chlorhexidine, please.

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-He's settling,

-he's back on the vent.

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-In the Special Baby Care Unit,

-a baby gives cause for concern.

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-De-sat first?

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-The sat goes down.

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-The baby isn't coming off

-the ventilator as well as we'd hope.

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-He was born at 30 weeks,

-and not 40 weeks.

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-His lungs

-aren't working as they should.

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-We can keep babies

-here for 24 hours.

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-But after that, their needs

-become more serious and complex.

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-We move them to a bigger Unit,

-usually to Glan Clwyd.

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-But Glan Clwyd and Wrexham are full.

-Arrow Park is the next hospital.

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-I need to contact Arrow Park

-to see if they can come and get him.

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-He'll be treated for longer there.

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-I'm trying to find a bed for him.

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-OK?

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-OK, lovely.

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-Great, thank you. Bye-bye.

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-There's a bed in Arrow Park.

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-They have a special ambulance

-for premature babies.

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-The sooner the better they arrive.

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-No-one wants to move babies late at

-night. It's easier during the day.

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-The next step is to tell his mother.

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-I've told her the baby

-might go to Glan Clwyd or Wrexham.

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-I didn't mention

-he might go further.

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-It's a staff training day.

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-The Clinical Skills Lab

-is part of our training.

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-We practise on the mannequins.

-There are three adults and a baby.

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-They move and breathe.

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-They can open and shut their eyes.

-Some can bleed and sweat.

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-We can give them fluids and drugs.

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-Today's scenario is that

-a patient has arrived in Recovery...

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-..and everything goes wrong.

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-..and everything goes wrong.

-

-Hi, Glen.

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-Gary Wright has had

-an arthroscopy on his right knee.

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-He's fit, doesn't smoke

-and has no allergies.

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-He regularly takes Co-codamol.

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-Thank you.

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-You're welcome.

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-Are you going back to theatre?

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-Are you going back to theatre?

-

-Yes.

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-Are you alright?

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-Things usually go smoothly.

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-If things go wrong...

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-..we practice so we know

-how to deal with emergencies.

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-Gary, Gary, it's time to wake up!

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-Gary, open your mouth for me.

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-We trying to get him

-to react as if he's lost blood.

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-I've entered his pulse rate.

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-I change his blood pressure

-to reflect the blood loss.

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-When they do the right things,

-I reverse things.

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-If they are incorrect,

-I can worsen his condition.

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-The on-call anaesthetist, please.

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-Can you phone Theatre 4?

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-Can you phone Theatre 4?

-

-Yes.

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-His blood pressure is lowering.

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-Gary, everything's fine, OK?

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-I'm just checking your leg dressing.

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-It's still low.

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-It went quite well.

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-I take the patient

-to Glenys in Recovery.

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-I left

-but was told something was wrong.

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-I went back

-before the anaesthetist arrived.

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-Glenys was in charge of the patient.

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-I was there to help her.

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-It proves we can work as a team.

-We know what we can do.

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-Sometimes we overstep the line.

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-Surgery is finally over

-for Rheinallt Jones.

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-He's now half an hour in Recovery.

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-How are you feeling, sir?

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-Not too bad, thank you.

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-Not too bad, thank you.

-

-Can you lift your leg up, please?

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-OK. Can you bend the knee, please?

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-Bend it as much as you can.

-OK, straighten the knee, please.

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-Yes, you can straighten the knee.

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-Well done, sir.

-I'll see you in the ward later.

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-Once he's feeling better,

-he'll change to his normal clothes.

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-Within a couple of hours, if he's up

-for it, he'll be sitting in a chair.

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-They'll make him walk, using

-a zimmer frame and then crutches.

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-If he's fine, he'll do stairs,

-depending how he's progressing.

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-If he's fine, he'll

-be able to do the stairs today.

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-This mother receives bad news.

-He has to travel for treatment.

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-He'll need the ventilator

-for longer than 24 hours.

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-It's not that he isn't coping

-with the ventilator.

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-His numbers are absolutely perfect.

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-He's not able to maintain

-that without the ventilator.

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-But there is one problem.

-Ysbyty Glan Clwyd is full.

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-The next one is Wrexham,

-which is also full.

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-The next one after that

-is Arrow Park on the Wirral.

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-They've got a bed

-and they can come for him.

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-I'm sorry it's a long way.

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-But if that's where the expertise

-is, that's where he's got to go.

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-If he was my baby,

-I'd want him to go there as well.

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-I'll leave you to your lunch,

-sorry to interrupt.

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-Years ago...

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-..I decided I couldn't spend my life

-crying over other people's babies.

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-It sounds hard,

-but it's for my own sanity.

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-I'd be good for nothing

-if I kept getting upset.

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-If I cried everytime,

-I couldn't do my job.

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-It's a skill doctors learn,

-how to separate work from home.

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-On the next programme...

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-..the pleasure and pain

-of being a midwife...

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-..a prescription's journey,

-the hospital DJs...

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-..and will she recover

-in time for her holiday?

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-S4C Subtitles by Gwead

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Pobl bwysig y boileri, peryglon y peiriant sganio, llawdriniaeth pen-glin a bywyd bregus yr uned gofal arbennig i fabanod. The lives of staff and patients at Ysbyty Gwynedd, Bangor.