Oh [Music] attention all medical stuff robot wood for children for the first time we gain unprecedented access into Singapore's largest children's intensive care unit [Music] working in the ICU even if your feet are paddling furiously underwater you have to still be able to perform efficiently over 22 doctors and nurses work together every day to save children on the brink of death why not me why mister there is no room for mistakes we are like the gatekeepers they are the last line in this hospital there are no easy decisions we may have to let her go
we reveal the daily fight for survival of these little warriors and the staff who care for them you'll be very well this week Paulina selfish intentions she stole my opening along usually takes me about two hours three families watch their young children being put through difficult medical procedures where I know she's very stable and she successfully extubated had to say with no knowing whether their child will survive that 45 minutes of waiting is just crazy [Music] today three-year-old cynllun will be taken off a ventilator delivering oxygen into her lungs this procedure is called extubation but
no one knows if sinden will be able to breathe on her own after that ICU doesn't allow children Spilotro feeis oh this time around giving a reception we are able to actually let singing some other sister to actually come and visit her in case religious no no she she coming through unless we still have a chance for them to to see shuttle ho oh wow [Music] [Music] [Music] cynllun has spinal muscular atrophy a genetic disease that weakens her muscles progressively dr. mark is here to remove the ventilator which has been sin Lin's lifeline for the
last two weeks what's happened but I'm a my they confirm he said to us exhibition like this when why no she is very stable and she successfully extubated I have to say in her case I'm gonna sing 24-48 hours us kiss scenario is I took out the Jew and she just kind of had it she starts to be very quickly she looks away uncomfortable I'm gonna see at these I can do daddy mommy feel that no then my recommendation is then we started working to make her feel comfortable the morphine primarily is to make her
not feel uncomfortable with the fact that her oxygen levels are right so you and I now and when we normally have low oxygen levels we struggle tumor if it's almost you know we feel bit suffocated and what we're trying to do is take away that sensation so Alicia feels comfortable any conversation talking the parents about how do you want your child to die is never an easy one sin Lin's parents have faced this decision before previously they chose to put her back on the ventilator as she failed to breathe on her own but this time
they don't want to prolong her suffering if she fails to breathe on her own after the extubation her parents have decided not to put her back on the ventilator Romania me excuse me but a day after the excavation pantry is you bit worse than yesterday this afternoon my dad she saw stabilized a bit but we actually heard quite nice not better today not so good now here maybe a little bit sin Lin's lungs are filled with mucus which are blocking her Airways let's say the doctors face an impossible dilemma suction her in temporarily cut off
her oxygen support or do nothing and allow mucus to choke her air passage persecutions and a unike uh I don't know how strength the doctors decided they can't put off the suctioning any longer they need to remove the mucus blocking her Airways senior resident dr. Sudipta is standing by with a bag to resuscitate sin Lynn okay yeah the physiotherapists and doctors managed to successfully clear the secretions for now but cynllun is not out of danger Davina oral suctioning actually the child is saturated to 90% and neither beginning for about five minutes or so in the
high her a 1600 70s during the episode cynllun requires suctioning every three hours and every round of suctioning poses a risk to her life ting Shan and his wife are too anxious to leave similans bedside tonight they will be keeping a vigil in the hospital [Music] [Music] nine-year-old Marcus had a sudden viral attack on his heart for days he has been kept alive on heart bypass machine called ECMO that helps pump blood around his body oh wow I know this'll cover naughty always be okay after days and paralysis Marcus's incessant a request for water shows
that he has regained much of his energy we assessed Marcus today and his hot function actually is continued to show improvements and his heart rhythm is actually very stable now with the medications that were treating him with Marcus but Marcus is not in the clear being on the ECMO has put Marcus at risk of developing blood clots which could cause a stroke or heart attack he is now on blood thinners which may have contributed to bleeding in his lungs breakfast using a very well haha everybody know Marcus what authority [Music] Marcus has not yet recovered
100% of his heart function but the doctors decide that it is too risky to keep him on the ECMO machine [Music] but coming off ECMO means removing two very large tubes that are stuck into blood vessels in Marcus's neck it's a simple procedure but it's a very risky one when we remove tubes from blood vessels and their clots within it there's a potential risk that we dislodge those clots and they may travel to the rest of the body including the brain or the blood vessels supplying your heart in which case you get a stroke or
you can take this [Music] No [Music] chicken is preparing to send a cancer stricken child three-year-old alia in for an invasive stoma surgery [Music] the main reason opening the stoma ie the operation tomorrow bleeding which we had to keep a lot of blood product to make sure that she can grow very well to minimize a Riesling bleeding this is real because of her leukemia awliyas blood count and clotting function is low which put her a great risk of blood loss and death but a Leah's mom chicken has chosen to take the risk in exchange for
a faster recovery from a gut infection that could also turn deadly for alia because let's say ICU is a more intensive even conceiving it nearly an hour later Marcus's operation is still underway it will waken in half and the see how it goes but I can't remove whole coats I just flush out my flat so we'll just see how it goes dr. naka had to come out and explain to me that you know there were a bit of blood clots and he was having a little bit of worry of having a stroke in the brain
we can when if I out where Marcus awakes and check his new raw state that 45 minutes of waiting is just crazy [Music] Marcus has gone through an operation to remove him from an external heart bypass machine 45 minutes after the surgery Marcus finally comes to but the doctors don't know if he had suffered a stroke as a result of the operation if Marcus can move and talk he's in the clear [Music] we cannot read much just a little bit to raise okay as Marcus woke up and we assessed him he was back to his
usual self he was chatting with us in a way that we were quite happy that there was no major complications from the procedure or from the blood clots that were within his blood vessels it's like God has given me a second chance to care for him again so you know I should be very happy and I am very happy that I have an opportunity to to be taking care of him again awliyas procedure was supposed to take just two hours but the operation is taking much longer [Music] but this case I can need to rewind
instrument cos we don't want to open another one so is something that operating with only one hand which I usually can do to Han where's my chicken is hopeful that the operation will pay off it creates a stoma bag for earlier which collects stools from her intestines thus bypassing an infectious wound in the anus so it could heal faster [Music] [Music] what minute you take you know what [Music] there's no any complication of infection and so on I just routine this very spring down and it's the worst is over for alia [Music] but not for
cynllun after she was removed from life support her oxygen level starts plummeting her heart is beating abnormally fast a sign that she is in distress holistic doctor Lu and my wife was like telling me that she she she started your hands and legs started to be very cool so we probably will do lose her doctors decide to inject cynllun with morphine to keep her comfortable they may be going to an apartment [Music] basic [Music] wait [Music] in my years working in the intensive care unit the hardest lesson has been about letting go I think all
of us started in our medical journey wanting to cure wanting to fix something but I think technology and science is finite there's some things that we have no control over it's about the realization of saying when enough is enough when is any further intervention just going to cause more more harm more pain more suffering to my patients and their families go on to the tree [Music] we want to do as you carry her for the last show for the last time [Music] the planet and we we just want to stay by her side [Music]
