He will smile kind of nervously at the kid and point at himself! “Pascal.” Than at her. “Sashi?”

…Well, it does make sense that Merr-rayn needs to sleep, having been awake all night. Tsashi hopes she isn’t going too far away. And there’s even a new Healer, it looks like! That’s good. They must have lots and lots of Healers here, to be able to have someone with Lionstar day and night. 

She bobs her head. “Tsashi.” Points at him. “Pas-gal?”

Communication! Has occurred! 

(A lot less communication than Tsashi would prefer! She's tired and frustrated and she hates being confused about what's happening, she wants to know what they're doing to take care of Lionstar and whether he's getting better or worse and how likely it is that he's going to die. ...She also wants to not think about that last thing, but she can't have everything she wants, can she. She probably can't even have more information, right now, and being upset with and rude to the Healers keeping Lionstar alive is not going to help him or anyone. She smiles politely and stays where she is, watching.) 

And Pascal can get a thorough orientation to the current state of all of Lionstar's various tubes, wires, IV pumps, IV sites, wound dressing site, ventilator settings, etc. Marian is surprised but overall pleased to note that RT apparently fiddled with the ventilator settings while she wasn't paying attention; he's on a pretty high post-expiratory end pressure setting (PEEP) of 14 cmH2O, but his peak airway pressure is actually not too bad, he's getting decent tidal volumes, and the oxygen percentage on the ventilator is now at 80%! 

Lionstar does not love having the blanket removed, even briefly to check his dressing site (still neat and intact.) He's clearly not awake enough to be particularly aware of his surroundings, but his face scrunches, and it's more noticeable than before that his muscles are tensing. 

Also Marian is being reminded that he's still pretty filthy! The OR must have cleaned up his abdominal area, but they also left it stained yellow-pink with the chlorhexidine-iodine disinfectant, which is going to be impossible to get off now since much of it is under the occlusive film dressing covering the wound vac site, perfectly visible but untouchable. She managed to get his face and neck reasonably clean just via repeated rounds of wiping up his sweat and saliva, but his arms and hands and legs and upper chest are still full of embedded grime, now mixed with dried sweat in drippy patterns. The IV sites, which got swabbed down with alcohol wipes, are noticeably cleaner than the rest of him under their clear dressings. 

"...He came in pretty dirty." She's embarrassed about her failure to DO ANYTHING about that, even though it was at no point a sane moment to give him the thorough soap and water bed bath he badly needs. 

Shrug. "That's okay. I know you can't give people baths when they're hypothermic. Maybe I can risk it once his potassium is normal. - when's he due to be turned?" 

"...Um. I haven't really been turning him. We were going to right before the OR but that's when we noticed the wound necrosis and then it didn't happen. And then he was doing runs of V-tach when we moved him at all, so I've kind of been leaving it alone." 

Nod. "So he's been on his back all night? Uh. I don't really want to disturb him either, but maybe it'll go better once the potassium is done? That'll be at," he checks his sheet, "like ten or eleven. I'll put a note that we can reposition him then." 

"Sounds good." And for now they can get him tucked up and cozy under the Bair Hugger again. He clearly still needs it even if he's technically up to normal body temperature. 

Aaaaaaaaaand then Marian can go...? Home...? 

Rick is at the nursing station, and would kind of like a report on 201, who is after all technically supposed to be his patient. 

Uh. Marian's brain is apparently reporting that nothing happened with 201 during the entire night and there's nothing to say, buuuuuut she can try her best to stumble through a slightly more detailed summary of who she even is and what drugs she's on and stuff. 

And then. HOME. 

Well, technically she has to bundle up in her winter coat and boots, hauling her backpack with the long-empty lunchbox and coffee thermos she brought in at 3:15 pm yesterday, and stumble out into way-too-bright winter sun blazing off the parking lot snow. She retrieves her bike - it's the winter bike with studded tires - and hopes she's, like, in fact capable of safely navigating a 1km stretch of road. 

It's straight down Montreal Rd to her apartment, the road is nicely cleared and salted and the rush hour traffic is heavy but relatedly moving nice and slowly, and she makes it back to her apartment at 7:55 am and barely remembers to lock her bike and stumbles inside. 

Downstairs in her apartment is also unpleasantly bright, but upstairs still has the curtains pulled from when she wanted to sleep in past 10 am yesterday. Alarm, set for...ugh how close is a good idea to cut it...she'll live dangerously and set it for 2:30 pm. And strip off her coat, but she's way too tired to change into something less gross than scrubs before she flops onto her bed. 

Pascal likes it best when, in addition to a good organized report, he has time to sit down and supplement it by going over the chart. He...hadn't really been expecting to get that, today, but it sort of does seem like all the chaos and excitement happened on Marian's shift and are now mostly resolved? He goes in once to ease down the norepinephrine infusion, but other than that he's granted an uninterrupted twenty minutes. 

There are labs scheduled for 10 am with a note specifying "or when IV potassium orderset is complete", which means it'll actually be closer to 10:45. That makes sense but it's not on his sheet so he adds it. There are q1h blood sugars, which, you know, was probably completely self-evident to Marian because Marian is smart, but it's not on his sheet. He's not sure if Marian said it at some point and just didn't say it during the part of the report where he was writing down times to do tests. And aaaah he's actually 45 minutes overdue aaaaaah. Marian seems to have done one for 6 am and then not-unreasonably not remembered for the shift change top of the hour. It was 93 and the patient is on continuous D5 now and probably it won't matter that much if he spends another five minutes checking the chart and then does it. 

There's a social work consult marked as STAT. Pascal hadn't even known you could put in social work consults STAT. He's very confused until he goes in and reads the note and concludes that, yeah, having a minor who doesn't speak English or have any other known relatives sort of...living...in the ICU is not, like, great. 

It's weird not to have a bunch of scheduled 8 am meds. 'Lionstar' (he's trying to remember to call the patient by their actual name even if it's weird and foreign and he doesn't know how to spell it, it's really awkward when you're face to face with a patient and blanking on their actual name because you've been calling them by the room number to colleagues all day) doesn't really have any normal scheduled meds, as opposed to continuous IV infusions half of which are bizarre. He doesn't even need to mix new bags anytime soon, Marian was thoughtful and explicitly warned him to keep a close eye on the atropine bag because it goes fast. 

He takes the glucometer and his stethoscope into the room. ...And a jello cup and juicebox, half because it feels weird to go into a patient's room without his hands full, but also Sashi could probably use it. 

Tsashi is pretty sure she did not get NEARLY enough sleep, but it seems to be daytime now and so she supposes she's awake. She kind of wants more of the stuff to draw on but has no idea what it's called and didn't really want to go out of the room to look for it. 

She smiles at Pascal, apparently relieved and happy to see him, but then seems confused and dubious about the jello cup. 

Pascal brought her a spoon! He's pretty sure that kids like Jello. ...He can open it for her? And hand her the spoon and then act out eating with it? 

Oh is it food! Tsashi is definitely hungry, and can't remember where the food-room was, she was trying to pay attention but the house has TOO MANY ROOMS, it was hard enough finding the room with the weird river-in-a-giant-urn where people here are apparently supposed to relieve themselves. 

She sticks the spoon in - it's a very strange texture of food, sort of like pottage but without any chunks and somehow see-through?? - and takes a bite. 

Awwwwww. Pascal is glad that she likes Jello! 

He turns on the glucometer and gets it ready with the strip (important to do that first, he used to mix up the order a lot and end up with a nice drop of blood and nowhere to put it) and then gets out the lancet to prick Lionstar's finger for the blood sugar reading.

Unhappy grimace! Lionstar is maybe even trying to pull his arm away from the surprising painful thing, though not having much success at it. 

...Oh right he could probably have just taken blood from the art line. Marian did not specifically say she was doing that but he bets she was and just thought it was too obvious to mention. (Everyone is constantly thinking that things are too obvious to mention. Pascal really hopes that at some point someday they'll start to be obvious to him too.) 

He makes a note of it on his paper and then puts the glucometer down and goes to zero the art line. ...Probably he can do that without actually lying the patient flat even though you're supposed to.

Tsashi has managed to partially recover from the intense experience of Jello and is now savoring it while also watching intently. 

Awwww what a cute kid. ...Who really badly needs a shower. Also what on earth is she wearing. Maybe he can ask Adele to help the kid shower if she needs help. Pascal thinks that normally kids her age don't need help but she definitely looks like she's experiencing Jello for the first time and also, uh, has possibly not showered ever in her life. Anyway, he can't help a preteen girl get in the shower, that would be incredibly creepy. 

The patient has calmed down again from having his finger pricked.

(It also more or less stopped bleeding after a few swipes with the gauze, which has to be good, Pascal remembers Marian rambling about how her patient admitted with really low platelets was clearly getting better because her blood sugar check sites were no longer oozing excessively.) 

His blood sugar comes back at 89 mg/dL, which on the one hand is fine but on the other hand it did manage to go down even with D5 running at 200cc/h. 

Pascal is going to WRITE DOWN VITAL SIGNS, which is not actually necessary, the monitor syncs to Epic, but it's helpful for him to have numbers where he can easily reference them.