This post has the following content warnings:
Merrin working in Exception Handling
+ Show First Post
Total: 2626
Posts Per Page:
Permalink

(Khemeth is not going to look visibly upset in a way Merrin can pick up on, but he is in fact finding it kind of upsetting.) 

Permalink

"Sorry sorry sorry I just need to - where are you getting all of that - okay one second, one second, I'm giving you some painkillers and then I really do have to deal with this." 

GrossgrossgrossgrossGROSS Merrin is maintaining professional dignity but GROSS LUNG STUFF. 

Permalink

Kalorm is not having a good time with this and also his oxygen saturation is dropping pretty fast. And the bolus dose of IV painkillers seem to be tanking his blood pressure, despite the fact that Merrin is currently hurting him kind of a lot. 

Permalink

"That is not ideal," Merrin says mildly, and she would slightly like it if she had more than two hands, but this doesn't actually seem worrying enough to justify calling more people in. She raises the head of the bed higher, and Kalorm can have a minute or two of higher O2 concentration, and ugh she was so close to having him maintaining his blood pressure without any drugs helping, but apparently his circulatory system is even more sensitive to the side effects of the painkiller she used as a first-line option, and now his heart rate is at like 130 which it is not really supposed to be...

Permalink

Merrin is calm and so probably this is not something to completely panic about?

Khemeth's brain still sort of wants to make him panic about it, though. 

Permalink

Merrin isn't very worried. Kalorm does seem less visibly in pain now and his oxygenation is stabilizing again. 

"You are doing such a good job of coughing," Merrin says earnestly, and does one final pass with the suction, which still gets some secretions but a lot less. "I'm really really sorry. I'm going to try this different painkiller and if your blood pressure minds it less I can give you a continuous infusion of it and you'll be more comfortable." 

Permalink

The second-line IV painkiller is in fact much gentler on his blood pressure. Kalorm's pained expression smoothes out, his body relaxing. With his lungs cleared out a bit - at least for the moment - he's getting higher breath volumes with the same amount of ventilator support. 

He's also super not initiating any breaths above the set rate. 

Permalink

"That is also not ideal," Merrin says conversationally. "If it's causing you this much respiratory suppression then we are not going to be able to get you off the ventilator. I'm sorry waking up is so un-fun." 

Permalink

Khemeth, who is still faintly shaky from the stress reaction, squints at the EEG. "Is he awake enough to hear us now?" 

Permalink

Shrug. "I really doubt it. I'm guessing another half hour even if I switch the sedative infusion off all the way, and I sort of would rather not do that because he might completely panic, and also I'm not sure I have a good setup for controlling his pain yet." 

Permalink

"Is it normal for it to take this long? Is it normal for it to be hurting him that much just to cough?" 

Permalink

Merrin turns to actually make eye contact with Khemeth. "He's waking up about as fast as I expected. And we did open a giant incision in his chest yesterday, on top of the injuries he already had – I'm really not surprised he's in pain. I'm not worried at this point that anything is wrong we didn't already catch." 

She goes to clean up the inevitable saliva mess, only wincing internally. 

Permalink

Kalorm disapproves of having any more things in his mouth! He gags and tries to bite the suction tip. 

Permalink

"I'm sorry it's so uncomfortable but if you let me do it then I'll be done faster," Merrin mutters, with something that is perhaps a hint of (fond) exasperation. "....See, there, done, you're okay." 

Permalink

Somehow Khemeth had not actually been picturing "waking Kalorm up" as a process that would take multiple hours. 

He paces. 

Permalink

Prediction markets agree with Merrin on about how long to expect this to take, though Treatment Planning is mostly deferring to her on exact timing of sedative dose changes. 

Permalink

Another fifteen minutes. Kalorm is still basically out if they leave him alone, but reacting more strongly to being bothered. Still not following verbal instructions, so he's not awake-awake, but he's responding more purposefully to minor painful stimuli, grimacing forcefully and then trying to push Merrin's hand away rather than just squirming, even maybe trying to open his eyes. 

Permalink

Merrin looks delighted. "That's very good! You're getting there. I'm - just going to go a teeny bit further down on the sedative..."

She fiddles with the IV rate control console. He's now on only about one-tenth the original dose. 

"...Right." She looks over at Khemeth and Nerdel. "I know we would rather not restrain him because it'll scare him, but I am putting like nine in ten odds that he starts trying to pull tubes out before he's lucid enough to even understand instructions not to, let alone feel like following them. Just - you don't have to actually hold him down if he's not fighting us yet, but if you can sort of gently hold his hand or something, one of you on each side, and be ready to grab on more tightly if he tries to go for the breathing tube..." 

Permalink

Five more minutes, and Kalorm has not actually gone for any tubes yet but he is now flinching and half-opening his eyes in response to a loud noise. 

Permalink

Awesome! ....Also no more loud noises, it looked like he didn't appreciate it very much. 

Able to follow verbal instructions? 

Permalink

Nope. 

Permalink

Well, he's still metabolizing the sedative and also on a LOT of painkillers. Merrin is going to leave everything the way it is right now, and intermittently ask him to squeeze his mother's hand, and....wait. 

Permalink

Khemeth is not sure how something can be simultaneously so stressful and so boring. It's been like two and a half hours. 

Permalink

Kalorm isn’t the only one of her children who needs some taking care of right now. Khemeth needs a distraction.

Nerdel clears her throat. “Merrin, is it going to be too distracting for you if I ask about some of your sims? Khemeth told me about a couple that sounded very exciting.” 

Permalink

Merrin tries to actually consider this.

She is not, in fact, doing anything very cognitively difficult. Watching the screen of basic vital signs and the EEG tracing takes a tiny fraction of her attention and she has alarm parameters set to warn her anyway if something changes. The command center has a lot more people watching and someone will interrupt her if something seems to be changing and she didn't spot it. The Diagnostic summary thinks Kalorm will, at this rate, hit 'awake enough to understand verbal instructions' at some point in the next hour. She doesn't actually want him to wake up more abruptly than that, but she is, in fact, pretty bored. 

Also 'a quiet ambient conversation' is actually a pretty reasonable degree of environmental stimulation at this point; she can watch whether Kalorm is starting to respond to it more. 

[Personnel, check if reasonable?] she subvocalizes. 

Total: 2626
Posts Per Page: