Pennod 2 Ysbyty

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-Bangor's Ysbyty Gwynedd

-is a busy yet homely place.

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

-..serve the people

-of North West Wales.

-Every aspect of life is seen here.

-Excitement at the Accident Unit,

-joy at the Maternity Unit.

-They treat sick children

-and care for the elderly.

-Operations, deaths and births...

-..cleaners, chefs,

-maintenance workers...

-..and laughter.

-This and more in Ysbyty Gwynedd.

-The Special Care Baby Unit treats

-the youngest, most fragile patients.

-This Unit

-cares for tiny newborn babies.

-The consultant does a formal ward

-round on Tuesdays and Thursdays.

-The rest of the time,

-a doctor does the round.

-It's a Tuesday morning,

-so here I am.

-Usually, the babies are premature.

-Premature babies get problems

-with their lungs and stomachs.

-They're unable to digest food

-like a normal baby.

-We slowly sift through the problems

-we'd expect from a premature baby.

-We try to anticipate the problems.

-He hasn't had caffeine yet?

-He isn't breathing much,

-except for ventilation breaths.

-He's awake,

-but he seems comfortable.

-Just lying there!

-We're fairly busy.

-A baby was born last night.

-I'll tell

-his mother how he's doing...

-..and explain what

-we hope to do today and tomorrow.

-He was ten weeks early.

-He's not meant to be here yet.

-We'll see what his mother will say.

-Terrence Channing from Holyhead

-is having an MRI scan.

-He has throat cancer.

-We're scanning his throat.

-He's had a diagnosis from a biopsy.

-The doctors will study the scan...

-..and decide on treatment.

-It'll be difficult for the patient

-because he can't lie flat.

-He can't swallow

-or breathe properly.

-We need to take care.

-How are you doing?

-Have a cough and then swallow.

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

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

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-PATIENT COUGHS

-It can be a terrifying experience.

-They don't understand the situation.

-Once they see the scanner

-and talk to the staff...

-..they accept it has to be done,

-for their own good.

-This is the sound the patient hears.

-LOUD TONE

-They have headphones

-to listen to the radio.

-They can bring their own CD

-and we play that for them.

-It's a horrible sound.

-OK, how are you feeling now?

-OK.

-You're struggling a bit, are you?

-You're struggling a bit, are you?

-

-Yeah, just a bit.

-Can I do anything to help?

-Can I do anything to help?

-

-No, there's nothing you can do.

-OK. Are you ready to start again?

-OK. Are you ready to start again?

-

-OK.

-All set for today?

-Which knee are we doing?

-Rheinallt Jones

-is having a new knee.

-It's the second

-he's received in Ysbyty Gwynedd.

-You had the MRI scan

-a few weeks ago.

-I'm looking forward

-to having it done.

-I had the same surgery

-on the other leg eight years ago.

-I've been through it.

-They are made to measure.

-I hope they get the right joint.

-I wouldn't want to get

-somebody else's knee!

-Rheinallt Jones

-is Mr Muthu Ganapathi's patient.

-He uses the latest technology

-for the task.

-I've used computer guided surgery

-for almost four years.

-It's more precise

-than manual instrumentation.

-But it takes longer.

-We get an MRI scan of the patient's

-hip, knee and ankle.

-That goes through a software and

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

-I plan the whole

-knee replacement in the computer.

-I do a virtual replacement,

-planning the cuts...

-..what size prosthesis

-I need to use.

-It makes surgery much, much easier.

-My surgical time is reduced by half.

-Generally it takes about

-one hour, 20 minutes.

-But now I'm doing the majority

-of the surgery in 35-45 minutes.

-In the Baby Unit, it's a busy

-but enjoyable day for Dr Mair Parry.

-The birth of a child is the best day

-of most people's lives.

-I've shared that day with hundreds

-of families, which is lovely.

-It's an honour and privilege.

-But sadly, I wouldn't be

-there if everything was OK.

-But I do enjoy it.

-I like seeing the little babies.

-Shall we give him a fluid bolus?

-We need to try to get the rate down

-and maybe reduce the morphine.

-We'll try to reduce the rate.

-OK, happy?

-The nurses specialize

-in premature babies.

-They tend to just work here.

-Looking after a premature baby...

-..is unlike

-caring for a 10-year-old.

-They are specialist nurses.

-The middle room is like

-an Intensive Care unit for babies.

-They need different skills.

-It's quite technical

-and more than just feeding babies.

-A new patient arrives for a scan.

-Are you OK?

-Are you comfortable?

-We're doing the head and throat.

-They've found something.

-The X-ray was inconclusive

-so they sent him for an MRI scan.

-It provides

-a clearer view of the throat.

-He's a broad man.

-They usually find

-it more difficult to go in...

-..because of the scanner's size,

-so it's not always the weight.

-It's more difficult

-when patients are short and broad.

-We like people

-who are tall and thin!

-But a scan can be dangerous.

-The scanner is a big magnet,

-so metal is prohibited.

-The most serious problem

-is pacemakers.

-We change the patients here

-and ensure their pockets are empty.

-A patient insisted

-on wearing his own dressing gown.

-I could see a metal object

-in his pocket.

-He denied there was anything

-in his pocket.

-There was a nail in his pocket.

-The technology is amazing.

-We get brilliant images.

-It's great to know that these images

-are helping the patients.

-Rheinallt Jones

-is under the anaesthetic.

-He's ready

-for his knee replacement surgery.

-The surgery is performed

-300 times a year in Ysbyty Gwynedd.

-The continuously

-evolving techniques...

-..shorten the recovery period.

-Most patients walk the same

-day they've had a knee replacement.

-Some even go home that day.

-OK, starting!

-Rheinallt Jones's new knee

-was designed for him on a computer.

-The surgery itself

-takes less time...

-..the surgeon's work is easier

-and it makes better use of his time.

-The new pieces fit perfectly

-without having to reshape.

-The treatment, designed beforehand,

-will save time under the knife.

-Now we can see

-that it's fitting the bone.

-The holes are made already.

-I just need

-to make some holes and do the cuts.

-The leg is almost ready

-for the new knee.

-Incredibly, Rheinallt Jones

-will be on his feet...

-..and walking in a few hours.

-In part two,

-will the new knee impress?

-A race to find a bed for this baby.

-And rather unusual training.

-And rather unusual training.

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-Gary! It's time to wake up!

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-In the boiler room,

-a machine gets an annual service.

-Alright?

-It's a yearly on the boiler.

-We open it up...

-..clean out the tubes,

-test the gas...

-..test the gas pressure...

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

-..to make sure it's burning

-properly, that the CO is correct.

-These boilers heat the water...

-..and power the central heating.

-The water

-goes through heat exchangers...

-..which provide domestic hot water

-for baths and sinks.

-We also send steam to the kitchen

-for the hospital's food.

-The hospital couldn't carry on

-without this place.

-They'd freeze in the winter

-and roast in the summer!

-Everything here

-has to be in working order.

-It doesn't matter if a bulb fuses,

-there are half a dozen of them.

-But if one of these boilers go,

-they'd soon run out of hot water.

-Very few people know what

-happens in here. They've no idea!

-We're sweated buckets

-in here over the years.

-Things are hotting up

-in the theatre, too.

-Surgeons prepare to put the new

-knee in Rheinallt Jones's leg.

-A special cement is used on the

-bone to hold the new piece in place.

-It's a perfect fit, but

-it'll take an effort to position it.

-Stop.

-Make the knot, please.

-It's good.

-You can see the knee

-is straight and it moves nicely.

-The kneecap is tracking,

-and that's one of the problems.

-It's precise.

-It's balanced nicely.

-I'm just going to close it now.

-Chlorhexidine, please.

-He's settling,

-he's back on the vent.

-In the Special Baby Care Unit,

-a baby gives cause for concern.

-De-sat first?

-The sat goes down.

-The baby isn't coming off

-the ventilator as well as we'd hope.

-He was born at 30 weeks,

-and not 40 weeks.

-His lungs

-aren't working as they should.

-We can keep babies

-here for 24 hours.

-But after that, their needs

-become more serious and complex.

-We move them to a bigger Unit,

-usually to Glan Clwyd.

-But Glan Clwyd and Wrexham are full.

-Arrow Park is the next hospital.

-I need to contact Arrow Park

-to see if they can come and get him.

-He'll be treated for longer there.

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

-OK?

-OK, lovely.

-Great, thank you. Bye-bye.

-There's a bed in Arrow Park.

-They have a special ambulance

-for premature babies.

-The sooner the better they arrive.

-No-one wants to move babies late at

-night. It's easier during the day.

-The next step is to tell his mother.

-I've told her the baby

-might go to Glan Clwyd or Wrexham.

-I didn't mention

-he might go further.

-It's a staff training day.

-The Clinical Skills Lab

-is part of our training.

-We practise on the mannequins.

-There are three adults and a baby.

-They move and breathe.

-They can open and shut their eyes.

-Some can bleed and sweat.

-We can give them fluids and drugs.

-Today's scenario is that

-a patient has arrived in Recovery...

-..and everything goes wrong.

-..and everything goes wrong.

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-Hi, Glen.

-Gary Wright has had

-an arthroscopy on his right knee.

-He's fit, doesn't smoke

-and has no allergies.

-He regularly takes Co-codamol.

-Thank you.

-You're welcome.

-Are you going back to theatre?

-Are you going back to theatre?

-

-Yes.

-Are you alright?

-Things usually go smoothly.

-If things go wrong...

-..we practice so we know

-how to deal with emergencies.

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

-Gary, open your mouth for me.

-We trying to get him

-to react as if he's lost blood.

-I've entered his pulse rate.

-I change his blood pressure

-to reflect the blood loss.

-When they do the right things,

-I reverse things.

-If they are incorrect,

-I can worsen his condition.

-The on-call anaesthetist, please.

-Can you phone Theatre 4?

-Can you phone Theatre 4?

-

-Yes.

-His blood pressure is lowering.

-Gary, everything's fine, OK?

-I'm just checking your leg dressing.

-It's still low.

-It went quite well.

-I take the patient

-to Glenys in Recovery.

-I left

-but was told something was wrong.

-I went back

-before the anaesthetist arrived.

-Glenys was in charge of the patient.

-I was there to help her.

-It proves we can work as a team.

-We know what we can do.

-Sometimes we overstep the line.

-Surgery is finally over

-for Rheinallt Jones.

-He's now half an hour in Recovery.

-How are you feeling, sir?

-Not too bad, thank you.

-Not too bad, thank you.

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-Can you lift your leg up, please?

-OK. Can you bend the knee, please?

-Bend it as much as you can.

-OK, straighten the knee, please.

-Yes, you can straighten the knee.

-Well done, sir.

-I'll see you in the ward later.

-Once he's feeling better,

-he'll change to his normal clothes.

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

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

-They'll make him walk, using

-a zimmer frame and then crutches.

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

-depending how he's progressing.

-If he's fine, he'll

-be able to do the stairs today.

-This mother receives bad news.

-He has to travel for treatment.

-He'll need the ventilator

-for longer than 24 hours.

-It's not that he isn't coping

-with the ventilator.

-His numbers are absolutely perfect.

-He's not able to maintain

-that without the ventilator.

-But there is one problem.

-Ysbyty Glan Clwyd is full.

-The next one is Wrexham,

-which is also full.

-The next one after that

-is Arrow Park on the Wirral.

-They've got a bed

-and they can come for him.

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

-But if that's where the expertise

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

-If he was my baby,

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

-I'll leave you to your lunch,

-sorry to interrupt.

-Years ago...

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

-crying over other people's babies.

-It sounds hard,

-but it's for my own sanity.

-I'd be good for nothing

-if I kept getting upset.

-If I cried everytime,

-I couldn't do my job.

-It's a skill doctors learn,

-how to separate work from home.

-On the next programme...

-..the pleasure and pain

-of being a midwife...

-..a prescription's journey,

-the hospital DJs...

-..and will she recover

-in time for her holiday?

-S4C Subtitles by Gwead

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