Segments in this Video

A Delicate Balance: Great Ormond Street: Introduction (01:34)


Doctors treat thousands of children each year. A small number of them are dependent on medical science to stay alive. Parents and doctors must consider how far to push treatments.

Maisie Harris (03:29)

Maisie has Ondine’s Curse and Tracheomalacia; her airways have been collapsing. Dr. Andy Petros considers the dilemma of ventilator treatment. Doctors meet with Maisie's family.

Maisie's Complicated Health (03:38)

Petros believes families need to know the "total picture." Doctors are unsure if Maisie will ever be able to leave the hospital; she increasingly needs intensive care. Maisie's mother was born with Ondine's Curse and uses a ventilator at night.

Badger Ward (02:59)

Maisie seems to improve a few days later and doctors move her to the respiratory ward. The respiratory team discusses Maisie's case. Dr. Colin Wallis is concerned Maisie may never leave the hospital.

Millie Stalehurst (02:43)

Millie, 4-years-old, arrived in the ICU, suffering from septic shock and organ failure. The ICU team discusses Millie's complicated case; she has had several major surgeries.

Continuing Treatment? (03:48)

Dr. Paula Lister attempts to determine if continuing treatment is in Millie's best interest. Dr. Quen Mok updates Millie's parents on her condition.

Considering Palliation (02:32)

Lister speaks with Millie's parents about her prognosis. Millie died an hour later.

Familiar Care (02:21)

Lister states that most deaths in the PICU are the result of withdrawing care. Parents often become accustomed to the need for intensive care. Ceri-Ann Christie and Lisa Martins consider how quickly their children's health changes.

Franceska Christie (02:55)

Franceska has quadriplegic cerebral palsy, scoliosis, and chronic lung disease. The ICU team discusses Franceska's case; Lister considers the increasing use of technologies in patient care.

Franceska's Prognosis (04:15)

Franceska was unable to breath on her own after the ICU team removed the ventilator tube. A week later, Franceska still struggles and the multi-disciplinary team questions the benefits of continuing care. Franceska's mother considers her health.

Family Burden of Care (03:05)

Doctors talk with Franceska's family about her continued care and the possibility of going home. Franceska's mother is hopeful.

Manual Ventilation (02:21)

Maisie is out of ICU but the staff manually breathes for her several times a day. Maisie's face turns blue and Nurse Kate Harkus breathes for her.

Maisie is Unable to go Home (03:11)

The respiratory team discusses Maisie's case. Dr. Colin Wallis discusses Maisie's condition with her mother.

Managing Maisie (03:39)

Maisie's unstable condition puts pressure on the ward staff. Wallis is unsure if Maisie's parents fully understand the situation. Maisie's airways collapsed repeatedly and the team struggles to get her through the crisis; she eventually returns to ICU.

Continuing Acute Care (02:18)

The medical team questions Maisie's continued re-admittance to the PICU and her health condition.

Continuously Collapsing Airways (03:42)

ICU consultants worry about Maisie's progress. They discuss possible treatment options. Maisie's airways are too soft for an operation.

Franceska's on CPAP (03:12)

Franceska remains in the ICU. The medical team discusses Franceska's case; Wallis reviews her lung scans.

Potential Future Palliative Care (03:04)

Medical staff discuss Franceska's prognosis with her parents.

Defying Expectations (02:42)

Franceska stabilized enough to leave the ICU. Wallis discusses night time support and home care with Franceska's mother.

Patient Update (58:52)

Franceska remains at home with time night respiratory support. Maisie is 18 mos. old and is improving in the hospital.

Credits: A Delicate Balance: Great Ormond Street, Series 2 (00:45)

A Delicate Balance: Great Ormond Street, Series 2

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This program follows the intensive care and respiratory doctors at Great Ormond Street Hospital as they deal with difficult ethical decisions. Modern medicine means that most children who come here will get better and leave within a short time but some are so complex that they become dependent on technology to keep them alive. Parents and doctors must weigh up when to keep relying on technology, and when it is no longer right to continue treatment. A BBC Production.

Length: 60 minutes

Item#: BVL115646

ISBN: 978-1-63521-081-1

Copyright date: ©2012

Closed Captioned

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