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Jun 23, 2021 7:51 PM
there's a Sith loose in the hospital
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The woman's eyes are rolled back in her head, and don't respond to the penlight. Her nail whitens at the pressure and returns to its normal pink color when released; there's no other reaction.

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...This is confusing. It doesn't seem plausible that a head injury could cause such deep unconsciousness without having other visible effects, or at least affecting the woman's vital signs more. A drug overdose, maybe?

There doesn't seem to be any admitting doctor or even a resident in sight, so she starts off with a hasty physical assessment, as much as she can do when her patient is strapped down to a backboard and still mostly clothed. She listens to the woman's lungs and bowels, examines her skin for bruises or other injuries, checks if her eyes look sunken or her mucous membranes are dry - the paramedics got an IV line in and are running fluids, but not fast, and if she's been collapsed in a cave in the desert she could be very dehydrated. 

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Her lungs sound completely normal; her bowels are very quiet, and feel empty. She has no bruises or other current injuries, but a small collection of neatly healed burn scars on her torso and arms, each a rectangle about half a palmwidth across and a few inches long; one, on her hip, seems to be newer, slightly rougher and more sunken compared to the rest, which are old enough that there's no telling if they were gotten at the same time or separately.

She doesn't seem to be dehydrated at all, somehow.

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This is so confusing. Maybe she just wasn't there very long before they found her? If it were only overnight, it wouldn't be hot yet - maybe caves don't get hot period... 

She starts trying to flag down a resident, or anyone who's able and willing to write some admission orders. 

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The older, male paramedic is having some sort of altercation with the charge nurse at the desk. 

"Look, I need to give patient belongings to someone!" 

     "Patient belongings aren't normally this big! Where are we supposed to put it?" 

"Can you please just sign for it so we can get out of here?" 

     "I don't really want to sign for something if we can't store it - what is it?" 

"I figured an art project? Maybe she's prepping for Burning Man." 

     "...Well, I guess it wouldn't be the weirdest one I've seen." 

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Since her search-path takes her there anyway, Marian pauses by the desk, looks over the bizarre humanoid metal robot-looking thing. 

"I guess we could stash it in the clean utility?" she says, somewhat dubiously. "It could fit in a patient room but it'd be in the way." 

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The charge nurse thrusts a clipboard at her. "Can you sign for it, then? I don't want to get sued for losing someone's ten-thousand-dollar Burning Man project when I wasn't even the one handling it." 

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She should probably be suspicious or worried or something, but mostly Marian just wants to be back at the ICU as soon as possible. "Uh, right, sure."

She scrawls a signature, then tests whether she can lift it. 

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She might be able to if she had to, but the thing isn't much smaller than she is, and heavier for its size than a human.

It does turn out that the joints bend, though, with a pretty human-typical range of motion.

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Marian sighs. She'll...call for an orderly with a gurney or something. Or maybe she can sort of fold it into a wheelchair... 

There are wheelchairs right here, against the wall, so she tries this. 

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It takes a bit of doing - the joints take some effort to move, and then stay where they're put, whatever that happens to do to the thing's center of gravity - but she can get it into a wheelchair.

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Well, better than nothing. She wheels the wheelchair over and parks it at the foot of the gurney, then finally manages to flag down the resident on duty. 

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"I, um, haven't done ICU admission orders before - what do you need?" 

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Marian does NOT say 'I have no idea that's supposed to be your job', but not saying it takes a lot of willpower. 

"I mean, whoever's on for trauma will take over once she's admitted, I guess." She STILL doesn't know who and she's mildly scared it's one of the horrible surgeons. "We should get a head CT, they'll want that. And, uh, can I get orders for sedation just in case - she's not responsive at all but if she starts waking up, you know..." 

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The resident, over five minutes, can be talked through putting in orders on the computer. 

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And then, blessedly, finally, Marian has admission orders and she's called CT and checked they can take her patient and her stat order right now and they can get OUT of here. Granted, in order to go somewhere even more stressful, but it'll be one step closer to her nice comfortable well-organized ICU. 

She uses the phone line to call an orderly and instructs them to bring the weird art project in the wheelchair over to the trauma ICU whenever they have a chance; in the meantime she asks one of the care aides nicely to please watch it for her. 

Marian doesn't really want to wait for another orderly to head to CT, especially since her spot might get taken if she's late. She sighs and returns to the patient's bedside, glancing at vital signs and repeating her minimal neuro assessment - any changes? 

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Her heart rate is up to 58 and her blood pressure has risen by a couple of points; everything else is the same.

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That's prooooobably an improvement, but Marian is suspicious on principle of anything changing, so she narrows her eyes at the monitor for a few seconds before she starts disconnecting and/or swapping all the equipment in order to head down the hall. 

A minute of staring intently at the paramedics' bizarre model of ventilator settings still fails to reveal whether the patient is breathing on her own above the rate, but she thinks the report said the woman had been mostly breathing spontaneously with occasional apneas, and there's clearly nothing wrong with her lungs or O2 sats.

Another minute of hunting around fails to turn up the ED's usual transport ventilator, it probably got put away somewhere weird and Marian doesn't work on this unit and isn't up to speed on the various weird places to check. Maybe she'll risk just taking the ambu bag and oxygen cylinder for transport. It's not like a head CT takes long, and she'll be able to keep an eye on the patient's sats the whole time. 

She sets this up, unplugs the IV pump and wraps up the cord so it's out of the way, and goes to pull her propofol order from the PYXIS computerized-med-dispenser. At which point she runs into yet another stupid problem, which is that apparently her employee badge isn't set up to authorize her to withdraw meds in the ED. 

"Arghhh," she says under her breath, very quietly, and then spends thirty seconds caught in stupid indecision about whether to gamble and go without it, or go harass one of the staff nurses to get it. 

Her inner Alice-voice has a strong opinion on this topic, and also points out that her patient doesn't currently have a hospital bracelet to scan. Which would be very embarrassing if she had failed to notice it until getting to CT, and she needs to bother the charge nurse anyway to use the bracelet-printer. 

She does this. The patient's assigned random name, since she doesn't have any ID on her, is Forty-One, Orange. 

And then, finally, fiiiiiiinally, she's on her way down the hall, steering carefully with one hand awkwardly half-around the ambu bag while she keeps her thumb hooked around the gurney handle, watching the patient's chest to see if she's breathing spontaneously. 

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She's very well-behaved about it, yes.

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They reach the CT department, and Marian, fidgeting slightly with impatience, goes through the usual ritual of negotiating with the radiology tech on which equipment can go in the room with her patient and how they need to be CAREFUL, no, MORE CAREFUL, about her tubes and wires, and no the monitor needs to be angled so she can see it, and she wants the patient's hands restrained just in case... 

After five minutes, everything is finally ready, and she backs out and stands behind the glass and watches the monitor. 

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Everything looks fine, at least as far as Marian can tell.

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It's not like she's qualified to read CT scans or anything, but it's a relief that there's nothing glaringly wrong. 

A CT without contrast doesn't take long; the process of getting the patient slid back across the scanner bed onto the gurney, and all of her wires and tubes rearranged, takes longer than the scan itself. 

Within twenty minutes of her departure from the ED, though, she's trekking off again. Aaaaaaalmost there... 

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Her pod, when she reaches it, is completely empty of any nursing staff. Leg Lifts Lady in 111 is flinging her legs around and mouthing what are presumably obscenities. 

There are raised voices and alarm-sounds coming from the adjacent pod. It sounds like a dialysis machine is unhappy. 

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Marian isn't trained on dialysis and needs to get her patient settled anyway. She risks leaving the gurney next to the waiting bed and darting up to the nursing station to find someone, anyone, who can lend her their hands for the transfer. 

All the nurses in the unit are busy or unwilling to go that far away from their unstable patients. Which is reasonable of them but also FRUSTRATING. It takes another five minutes for the care aide to come back from the bathroom, and ten minutes before she finally has her patient in the ICU bed and is getting everything set up properly. 

Any changes? 

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Nope.

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