2008-02-12: Bad News at the ER


Bekah_icon.gif Cam_icon.gif

Summary: A boy comes into the ER with heat exhaustion… in February?

Date It Happened: February 12th, 2008

Bad News at the ER

Mt. Sinai Hospital, ER

It's morning, still, not quite noon when Cam's brought in by the Brubaker school nurse. The nurse at the triage desk assesses him and then sends him right in to a bed. The symptoms written on the chart: heavy sweating, vomitting, fainting, rapid heartbeat, low blood pressure, clammy skin, headache, and fatigue. All signs of heat exhaustion, but the nurse seems to have assumed something else because of the time of year. The boy lies in the ER bed he was given. The vomitting seems to have stopped for now, but he's looking very pale and still sweating quite a bit.

Bekah picks up Cam's chart at the nurse's station and flips through it. "Huh." She states at the symptoms before she heads over to the room Cam was stashed in. She looks the part of a doctor with a lab coat and stethoscope over her green scrubs and sneakers. "Cam Reynolds? I'm Dr. Morgan. What seems to be bothering you today?" Yes, she just read the list on the chart, but it seems she wants to hear it from him, even as she's putting her stethoscope in place to listen to his heart and lungs.

Cam's heart is beating a mile a minute, but his breathing seems clear. He nods a little, "Um… I got a headache and started throwing up in class and then fainted on the way to the nurse. I'm feeling a bit better now, 'cept my head still hurts" he adds.

Bekah nods her head. "I'm going to start an I.V. and get some fluids in you. I'm also going to draw some blood and check some labwork, alright?" She says, moving to finish a physical exam, checking his ears, throat, etc. It's all very practiced and matter of fact. "Were you feeling ill before class? Do you have any medical problems?" She asks, taking another look at his chart before she adds. "I'll have the school nurse try contacting your gaurdian again." Because lots of information finds its way there.

Cam nods a little to the explanation. Though he doesn't look too happy at the prospect of needles, he doesn't complain either. Then he answers, "Started feeling sick in second period. Been sweating all day, furnace was broken at school, and I sweat easier than most people I guess." From mostly calm (if a little scared) to almost panicked at the mention of calling his guardian, he shakes his head quickly, "No! Um.. she's out of town. She's… um.. on business."

Bekah looks over to Cam. "Do you have a number where she is? Someone staying with you while she's away that we can notify?" She asks as she moves to get supplies. For a kid, she'll even start the iv herself. "Was the furnace on full blast all the time or totally off?"

Cam looks hesitant but then nods, "You can call Monica, she's who I've been staying with." He gives her number. "But she's at school, at the university. I dunno her cell number by heart." Then he nods again, a little more relaxed at the change of subject, "Full blast."

Bekah pulls a stool and little cart up next to Cam's bed, sitting to get the needles ready. "I'm going to start out drawing your blood. It'll be a pinch, but I'm good at this." And humble, too. She cleans his arm, tightens one of those bands around the top and feels for a vien. If he cooperates, she'll poke a needle in as she talks. "You may have just overheated, but I'd like to check lab work and make sure there's nothing else going on. Either way, some fluids should help you feel better."

Cam holds his arm still for Bekah, but winces before the needle comes even close, bracing himself apparently. When it barely hurts at all, he blinks and relaxes again, smiling a little. "Yeah, you are." Then he nods and says, to the explanation, "Ok. Thanks." He watches as his blood goes into the vial.

Bekah takes a couple vials of blood before she takes the needle out, holding cotton over it with a gloved hand. "After awhile at this job you get pretty good at sticking people with needles." She jokes before she slaps a bandage on. And then she's cleaning another spot on his arm. "I'm going to go ahead and start an IV here." She tells him, and being the good needlesticker she is, Bekah even gets the needle seated in a vien the first time.

Cam holds his arm steady, and barely flinches this time as the needle goes in. "Last time I was here it hurt lots more. But, I had acid on my shoulder, so *everything* hurt more."

Bekah gives Cam a smile. "And last time you didn't have me doing it." She jokes as she tapes the needle down and stands to hook a bag of saline to the I.V. "And lack of acid burns are generally always a good thing. I'm going to go get this blood sent to the lab. Do you have a phone number for Monica? Even if she's at class, we need to give her a call."

Cam smiles back and nods a little. "Yeah." Then to the last question he shakes his head a bit, "Not by heart. It's written down by the phone at home. Are you sure ya gotta call? I'll be ok here. My foster mom'll be back in a few days, and she can come talk to you then."

Bekah shakes her head. "We really need to contact her. And your foster mom if at all possible. We need someone to authorize your treatment. We can do what you need immediately, but anything beyond immediate needs, like hydration, we need someone to sign for." And she's not going to bring up calling his social worker instead, yet. Don't want him to run off.

Cam ohs, and bites his lip. Thinking quickly, he remembers the company Niki said she was staying with, and quickly suggests, "My foster mom works for a company called Pinehearst. You could call them, they might know howta find her." Of course, as a foster child, all hospital visits have to be reported anyway, but he doesn't know that, so he's scrambling for options.

Bekah nods her head. "Pinehearst. I'll have it hunted down." It's good to have minions. Some medical student can find the number for her. "You rest for now. I'll be in to check on you soon, and probably more nurses than you really want to see." And probably his social worker, as well, once Bekah puts in that call. Or has a minion do it.

Cam nods a little to that and says, smiling, "Ok." Believing that he won't have to worry now, he leans his head back again and just sits there, cooling off. His blood tests come back clean, and indeed it turns out to be heat exhaustion. He slowly seems to be recovering, now that he's in a cooler environment. Shortly after being called, only accounting for time spent in traffic, the social worker shows up. Looking rather unhappy.

Bekah is just making her way back with the chart balanced along with a cup of coffee and a small pile of comic books when the social worker shows up. Hearing the worker check in at the desk she gives the unhappy woman a much more cheerful than normal smile. There's nothing more fun than being cheerful to grumpy people. "Good day. I'm heading back to check on Cam now. You can follow me. Dr. Morgan, by the way."

The social worker nods to Bekah and steps to follow. "Jess Fountain. Nice to meet you." Grumpy as she is, she's still polite, though frowning just a touch more in the face of Bekah's cheerfulness. As they walk, she asks, "What is the boy's condition? Will he need to stay overnight?"

"I'd like to run another liter of saline and continue to monitor his vitals before I make that decision, but if he is doing very well, he could be discharged this evening. Otherwise, I might try find a bed for him in peds for the night." Bekah's tone is professional, but she's still sticking in a bit of the annoying cheerfulness, just to watch the woman's reaction. "Cam came in with symptoms of overheating." In February.

Jess nods, frowning all the more, "Of course. His new foster family will be ready to take him as soon as he's released." Just like that. She then blinks, scowl fading into a look of surprise, at the cause of the hospitalization. "How is that possible?"

Bekah shakes her head. "I don't know." She admits. "He said that the furnace was broken at school and wouldn't turn off, but he was the only one brought here from the school." So none of the other kids must have been as sick as Cam. "You found a new foster family for him already?" She asks with surprise, pausing outside his door, to try to keep this conversation from him.

Jess nods, and seems to be softening now. Maybe preparing herself for facing Cam. In any case, she says, "His last worker was murdered when she went to remove him from his foster family, along with the family's natural son. You can understand things have been chaotic. The father turned himself in for the murder so I assumed he was the dangerous influence and set the case aside until I could get a handle on the case and all the others that ended up on my desk. I made a mistake." And thus her bad mood. "But his new foster family's been picked since that happened, all I had to do was make sure one of them was home today."

Bekah nods her head before she adds. "Could have been a worse mistake." After all, with years of ER work under her belt, Bekah has seen things worth calling in a social worker. Instead she just opens Cam's door and steps inside, letting the social worker in as well. "How you feeling? I went and raided some comics from peds. I couldn't convince them to let me steal a video game, but at least it's something." She states, dropping the comics on Cam's lap to sip from her coffee.

Cam is looking quite a bit better than he was. He's still a little pale and damp, but the sweat isn't pouring off him like it was. He brightens immediately as the comics are dropped in his lap, "Oh, awesome. Thanks!" He flips through the comics a moment and then answers, "I'm ok. Not as hot anymore." Jess stands back for now, waiting and watching Cam. Assessing him, probably.

Bekah pulls out the cold stethoscope again for another listen to Cam's heart. The coffee is set aside to check on her patient. "Good. How is your headache? Still feeling sick to your stomach?" She quizes.

Cam shakes his head a bit and says, "Still got a bit of a headache, but not as bad. Stomach's fine now. Except I'm kinda hungry," he adds with a bit of a grin. "I missed lunch." His heart sounds a lot better too. Still a bit faster than should be normal for his weight. He'll probably need to stay the night to recover fully.

Bekah straightens up to check on the much lower level of the saline in the IV. "I think I can arrange for some wonderful hospital food for you." She says to Cam before her eyes move to Jess and she addresses the watcher. "I'm going to recomend keeping him overnight for observation. Better to be safe with someone this age." She states before Cam gets another smile. "Which means I'll see if we can get you moved up to peds. Much more fun there. TV and video games beat the plain old er."

Cam blinks, "I gotta stay?" But then he nods a little, brightening a little again at the description of 'peds', "Oh, ok, cool. Can Micah come visit? He'll find out whenever you get ahold of Monica anyway." Jess nods to Bekah and steps forward, saying gently to Cam, "That might not be the best idea. We need to talk…"

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