4:02pm
A shift pattern for Letby for June 2016 shows Letby worked long day shifts on June 8, 10, 11, 13, 14 and 15.
A doctor colleague says, on June 14: "Am I right in thinking you'll have done 6 long days in the last 8? No wonder you're tired"
Letby says at the end of her June 14 shift, for the handover of Child N's care to Jennifer Jones-Key: "I don't recall there being any concerns at that time" for Child N.
A nursing note by Lucy Letby for June 14 is shown to the court. It includes: '...repeat SBR this morning on downward trend but not yet >50 below treatment line but otherwise ready for home'.
Letby says Child N was being treated for jaundice and required further phototherapy. Once that was complete, he was ready to go home.
Jennifer Jones-Key notes: '...baby very unsettled early part of night. Inoticed that just after 0100 feed baby looked very pale, mottled and veiny. Abdomen slightly bigger - seen by NNU nurse Belinda Simcock, advised to place baby on saturation monitor...after 30 mins noted to be having desaturations to low 80s, no intervention required but quite frequent. Rest of observations within range....baby looked worst this morning...10% dextrose commenced...'
Letby agrees Child N deteriorated during the night.
'...at 0715 baby crying and dropped saturations - seen by NNU nurse Lucy. Neopuff given with 100% oxygen...noted to be mottled all over body and blue in colour and cold to touch. Decision made to transfer to nursery 1... At handover baby dropped saturations again and required Neopuff. Care handed over to NNU nurse Lucy Letby'.
Swipe data shows Letby and a colleague entering the neonatal unit before 7.15am, in time for the 7.30am shift.
Letby recalls she went to nursery room 3 to talk to Jennifer Jones-Key "She was a good friend of mine" - as part of getting ready to work. The handover had not yet taken place "not that I'm aware of".
She said the chat happened and "within minutes" Child N's monitor went off and Child N appeared mottled. Letby says Jennifer Jones-Key was tending to another baby. Letby says she was within the doorway and had not entered the room.
Child N was in a cot by the doorway. Letby said she went straight over to him and he was a 'bluish colour' and she called for help.
Letby says Jennifer Jones-Key finished what she was doing and came over to help.
A registrar doctor came over almost immediately to help. Child N recovered from the initial episode but deteriorated again "very quickly".
"His colour was not good, he was mottled, and the decision was taken to move [Child N] to room 1".
Letby says she had been in the unit for "minutes".
The docotr said the decision was made to intubate Child N.
Letby tells the court she got the equipment ready for intubation, including routine drugs.
4:10pm
A neonatal schedule shows Letby assisted in the administration of medication for Child N at 8am-8.06am.
Letby is asked if she saw blood at some point during the intubation process. Letby says she does recall that, but cannot recall at what point that was.
The doctor's notes: 'Attempted intubation x3...using size zero blade. Blood present at oropharynx. Unable to visualise tracheal inlet. Suction did not clear the view. Intubation abandoned due to blood present...oropharynx...trauma due to repeated attempts.'
Letby recorded in her notes: '...unable to intubate - fresh blood noted in mouth and yielded via suction ++'
Letby tells the court her interpretation of the note is the blood would have appeared after the attempt to intubate.
The trial of Lucy Letby, who denies murdering seven babies at the Countess of Chester Hospital neonatal unit and attempting to murder 10 more,…
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