Crash- Station 19/Marina

ER

They arrived at the hospital just before 5am and headed into the ER. Carina was annoyed at their luck as she brought Maya into the ER to find that no one they knew was working in the pit this early today. Carina had met the doctor running the ER at work but they didn't know each other well and he didn't know Maya.

"Good morning Dr Deluca, what are you doing here this early?" He asks, Carina doesn't remember his name.

"My wife is sick, I came to get her checked out. Do you know if Dr Grey or Dr Shepherd are working?"

"They're not, I can take care of her, I'm sure we don't need surgeons"

"Ok, they just know her history"

"She can have bed 3, does she have a chart here?"

"Yes, Maya Deluca-Bishop, thank you"

Carina brought Maya over to the bed, adjusting it so she'd be sitting up before lifting her onto in case she threw up again, which had happened in the car.

After a few minutes the doctor came over to them.

"So what are her symptoms?"

"She's been tired and not feeling well for days, yesterday she was congested and extremely tired, she had a low grade fever last night when we went to bed but when I checked an hour ago it was up to 104 and she started throwing up, it's been hard to keep her awake."

"Did you try giving her medication to reduce her fever?"

"She was already taking Tylenol for pain"

"What pain?"

"Neck pain from her injury"

"Ok, someone will take her vitals and we'll see if she needs to be here"

That concerned Carina, Maya did need to be here. An intern came over to take her vitals, her oxygen was a bit low, temp still 104 and high blood pressure. Seeing that Carina decided to text Amelia.

'I know you're not working yet but I brought Maya into the ER. She's sick and her fever got too high, they just took vitals and her blood pressure is also high'

A minute later her phone rang, Amelia calling her. Carina explained what was going on and Amelia decided she was coming in as well as calling Maggie who was working. A few minutes later Maggie came into the ER.

"Hi Carina, Maya, how are you feeling?" Maggie says as she walks over to them. Maya didn't respond but started choking again so Carina quickly pulled her up, sitting behind her and helping her cough.

"Ok" Maggie says, grabbing her stethoscope and stepping closer. "What's going on"

"This started yesterday, when we went to bed she had a mild fever, this morning it was up to 104 and she started throwing up so I brought her in"

"Car, wanna go home" Maya mumbled having woken up again.

"Maya, I'm going to listen to your lungs" Maggie tells her before pulling her shirt up and putting the stethoscope on her back, listening for a while before switching to her chest.

"Lung sounds aren't good. What's her lung function usually like?" Maggie asks turning to Carina

"She has fairly good control of her diaphragm but no control of the intercostal or abdominal muscles so no cough, deep breath or forced exhaling"

"Ok, I want a chest X-ray to check for pneumonia but I'll wait until Amelia gets here. I want her admitted but I'll talk to Amelia about what unit she should be on. Keep doing the assisted cough when she needs it and I'll get someone to bring a suction machine over until you get a room"

"Thanks Maggie"

"I have to go check on some things but I'll check in with you again in a bit" she says before  leaving.

About 15 minutes later Amelia got there and came straight to them and started taking Maya's vitals again.

"Her BP is too high, I think it's autonomic dysreflexia" Amelia says

"That's what I was worried about when they took her vitals, that's why I texted, they didn't seem concerned"

"A lot of people don't know about it but they should. Let's try to find the cause, I'll order bloodwork and a urine test. If she has the binder or compression socks on they need to come off. I'm going to get her meds to lower her blood pressure and fever and grab a cooling blanket to help get her temp down since she can't regulate her temperature. A lot of her symptoms could be caused by AD so our first priority is figuring out what's causing that and fixing it"

The next hour was very busy as they ran all the tests and moved her to a room then it calmed for a bit while they waited for the results. Maya started to wake up more as her fever came down.

"Car, what happened?" Maya says as she wakes up and sees she's in the hospital.

"Your fever got really high overnight so I brought you in, you were very out of it. Your fever's coming down now and we're waiting for test results." Carina explains, climbing into the hospital bed beside her wife. "You also have AD so they're trying to get your blood pressure down and find the cause of that"

"Why can't I just be sick for a few days at home like a normal person?" Maya complains, trying to hide in Carina.

"I know, hopefully you won't be here long" Carina notices what Maya is trying to do and moves them so they're closer together. A few minutes later Maggie and Amelia come in.

"Hey Maya, nice to see you with us again, I guess your fever's come down" Amelia says

"Ya, I don't even remember coming here. I still feel like crap though."

"Well that's because you've managed to get a UTI and pneumonia. The UTI is probably causing the autonomic dysreflexia and either could be causing the fever. We're going to start you on antibiotics and keep you here at least until the AD resolves and your blood pressure's stable" Amelia explains.

"I'm going to put you on oxygen and start breathing treatments twice a day for the pneumonia and I'll keep monitoring you. Coughing is important to clear your lungs so let someone know whenever you feel like you need to cough." Maggie adds

"I can't tell if I need to cough until it's really bad" Maya tells her

"That's ok, we'll monitor you. I'll check in with you before my shift ends but you can page me if you need something" Maggie says before leaving.

After a breathing treatment and starting on oxygen Maya managed to sleep for a while. Carina also started to doze, having got very little sleep the last 2 nights and being slightly less worried now that there were monitors that would alarm if anything was wrong with Maya.