Anya's Story

Anya was one of four teenage girls rescued from a house fire in Llanelli in December 2007. Initially admitted to Morriston Hospital Burns Unit for treatment to her facial burns, she also required artificial ventilation. After any type of injury, the body produces an ‘inflammatory response’, mobilising a small army of specialist blood cells and proteins to promote recovery. When someone sustains a severe injury (including a burn), their body can sometimes a much stronger response than necessary, and instead of helping the injured area to recover, the army of cells and proteins causes some of the body’s organ systems to function much more poorly, or even go into shut down. This is what happened to Anya, and it affected her lungs particularly severely, causing them to become very inflamed and to fill with fluid. In fact, of all the girls admitted to Morriston, Anya’s burns were the least severe.

After 3 weeks in the Burns Intensive Care Unit, Anya’s lungs were becoming worse. Many areas of her lungs were solid and collapsed, impossible to ventilate, and it was becoming very difficult to keep her blood oxygen levels at an acceptable level, even though the ventilator was at maximal settings. Her oxygen levels were what you might expect in a mountaineer climbing Everest without oxygen – despite the fact that she was receiving almost pure oxygen from the ventilator. The Burns Unit team contacted PICU to ask for their help. The PICU team thought using a specialist type of ventilator called a high frequency oscillator, often used in very small babies, may help Anya’s lungs to recover. However, using this type of ventilator for older patients requires specialist knowledge and experience to operate only available in Cardiff. Anya was also so difficult to ventilate that the Burns Unit staff in Morriston had difficulty in giving her routine care without her oxygen levels dropping, let alone moving her 40 miles.

PICU sent out a their specialist team – consultant paediatric intensivist, paediatric intensive care nurse, and ambulance driver - all trained and experienced in transporting sick children. The team were able to transfer Anya onto specially adapted portable equipment and transport her in the PICU ambulance, back to Cardiff. This is made as safe as possible, because this specialist vehicle has been specially designed as a mobile paediatric intensive care unit. Once in PICU, she received high frequency ventilation. This type of ventilation is good at opening up parts of lung that have collapsed, and preventing other areas form collapsing, and at the same time, has a much gentler action on the lungs, preventing further damaging inflammation.

Anya spent 20 days on PICU, and eventually her lungs began to recover. After 2 weeks she was put back onto a normal ventilator, and this was quickly turned down and she was able to breathe on her own. Anya’ sister had received burns in the same fire, and was still in the burns unit in Morriston, and Anya was desperate to see her again. Once we were confident that her lungs had recovered, Anya was transferred back to Morriston to continue her recovery closer to home.

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