A senior nurse says she was "kept up at night" by the "horrific" sight of a toddler who was allegedly murdered by his grandparents.
Two-year-old Ethan Ives-Griffiths died from a catastrophic head injury in August 2021.
Michael Ives, 47, and Kerry Ives, 46, both of Garden City, Flintshire, are charged with murder, causing or allowing the death of a child and cruelty to a child, while Ethan's mother, 28-year-old Shannon Ives, of Mold, is charged with causing or allowing the death of a child and cruelty to a child.
All three deny the charges.
Ethan was unconscious when he was taken from his grandparents' home to the Countess of Chester Hospital on 14 August 2021.
Stephanie Pearson, who was the senior sister on duty that night, became tearful as she told the trial at Mold Crown Court on Wednesday how the child was bruised, looked "extremely malnourished" and was "skin and bone" when he was handed over by paramedics.
"I have seen a lot of things in 20 years…this kept me up at night," she told the jury.
"He appeared a very, very frail young boy."
