Monday came and went, and Meghan and Fred were up to their eyeballs in new EMT – Paramedic students. The first day was orientation, so all of the mundane stuff about introductions, course syllabi, classroom expectations, and orientation to the building and the classroom were dutifully gone over and discussed. Tuesday was a repeat of Monday, except this was the two EMT – Basic classes, one in the day, the other in the evening.

Wednesday the paramedic students returned, eager to begin their coursework. Meghan gave the first lecture, then handed the class over to Fred. She headed to the office and sat down, tired for some reason. Sitting at the desk, she laid her head down for a minute.

Hands shook her awake. “What? I just put my head down for a second,” she protested.

Fred shook his head. “You’ve been in here for a couple hours,” he countered. “How are you feeling?”

Meghan shook her head to try to clear it. “Tired, and kinda fuzzy,” she admitted.

“Be right back.” Fred left the room to get a blood pressure cuff and his stethoscope. He returned to where Meghan was sitting. “Let’s check your vitals, hon. You’re awfully pale.”

He wrapped the cuff around her arm and took her blood pressure. Meghan watched him as the cuff deflated. “What is it?”

“You’re at 88/42. What do we need to do for you?” Fred left the cuff in place for the moment and popped a pulse ox onto her finger.

Meghan groaned. “I guess I need to do my backup cortisone and head to the ER. I need to call Mitch.”

Fred nodded. “Is your cortisone in your backpack?” She nodded. “Go ahead and call Dr. Branston while I get it drawn up for you.” He pulled over her backpack and started digging while she pulled out her phone and dialed.

Meghan shook her head in frustration when she got the answering machine. Dr. Branston must be at work. She sighed and dialed the ER. It took a couple of minutes, but she finally heard his voice on the other end of the phone.

Branston speaking.

“Hi Mitch. I need some orders from you.” Meghan glanced at Fred, who was holding up a filled syringe. She rolled up her right sleeve for him as she spoke on the phone.

What’s going on, Meghan? What do you need?

“Well, my blood pressure – ouch! – is low. Fred is giving me the emergency cortisone now. I will find a ride to the ER, but I’m wondering if we should go ahead and start some fluids, as well.” Meghan rubbed her now-sore shoulder, giving Fred a look.

What’s your blood pressure? Mitch asked.

“88/42. And I’m feeling tired and out of it. Came on quickly.”

You do need to come in, Mitch confirmed. Go ahead and run a liter of fluids and recheck your blood pressure. How soon do you think you can get here?

Meghan looked over at Fred. “Mitch wants a liter of fluids, and is asking for an ETA. Do you think we can find someone to drive me over? I’d rather not go by ambulance.”

Fred gave her an assessing look. “Well, I’d be happy to drive you myself. Do you think you can make it to the truck without passing out, though?”

Meghan grimaced. “I don’t think I’m going to pass out, but we could get someone to walk with us just in case?”

Fred nodded. “I’ll get someone from the Fire class to walk with you. Tell Doc it’ll probably be 15-20 minutes, and we’ll get that IV started.”

Meghan nodded and turned back to the phone. “Fred says he can drive me and get the IV going. So probably about 15-20 minutes.”

I’ll have a bed waiting for you. We’ll do labs, see what your levels are. I’ll call Dr. Woodruff and see what he orders.

Meghan hung up the phone, sighed, and held out her arm to Fred. “Let’s get me hooked up and out of here. Sooner I get this over with the sooner I can head home.”

Fred chuckled and set down supplies before hooking up everything for her IV. He got it inserted, adjusted the drip flow, and taped down the tubing. “There. I want to get another blood pressure, then see if Brad or Thom is available. I’ll need someone to cover the class until I get back.” He put his stethoscope in his ears and took the pressure. He let the last bit of cuff deflate with a hiss. “Not much change, but you’re up to 92/46 now. Not gonna pass out on me, are you?”

Meghan looked up at the dripping IV and back to Fred. “No, I think I’m conscious. Go get someone to help, please.” She settled back in her chair more and propped her feet up on Fred’s chair.

Fred nodded and, with a final look at her, left the classroom and headed next door to the Fire classroom. He knocked on the door and opened it, looking around at the lounging students until he spotted Brad. “Hey Brad. Can I see you for a minute?”

Brad looked up and nodded. He got up and motioned Fred into the hall. “What’s up?”

Fred sighed. “Meghan’s blood pressure has dropped on her again, and she’s not looking too hot. I’ve got her rescue meds into her and an IV started. Doc wants her in the ER, and she doesn’t want to go by ambulance, so I’m going to drive her. Would you help me walk her out to my truck, and keep an eye on my class until I get back? They’re at lunch until 1.”

Brad nodded. “Of course. Let’s get her out to your truck, and I’ll send Ted to watch your class until your arrival.”

The two men headed to the EMS office. They got Meghan up and helped her out to Fred’s truck. Secured inside and with the IV hanging from a handle bar hook, Fred started driving towards the ER. Meghan stared out the window, feeling miserable.

“How are you feeling?” he asked.

“Rather crummy,” she replied. “Lightheaded, nauseous, and my stomach is cramping.”

“Huh. Sounds more like the stomach flu than your usual symptoms.”

Meghan nodded. “Yeah, this feels like a bit of both, actually.” She looked up at the IV. “I’m going to open up the flow rate a bit more.” She adjusted the IV to drip a bit faster. “Wish I had some Zofran right now. Guess I’ll have to ask Mitch for some when we get there.”

Fred nodded as he pulled into the ER. “Wait here while I go get a wheelchair.” He parked in the drop-off area and headed inside.

Meghan closed her eyes and leaned back against the headrest. She had no desire to do anything but rest and wait for him to return.

Fred came back shortly with the chair and knocked on the window before opening her door. She released the seatbelt and eased it back into position, being careful to not catch her IV on the buckle. Fred assisted her into the chair, and wheeled her into the ER.

Bob met them at the double doors into the ER and directed them to Treatment 4. “Meghan, you’re not supposed to come visit me this way,” he chided as he helped her onto the gurney. “Let’s get you into a gown and get a new set of vitals.” He helped her undress to underwear and into a gown before hooking her up to the cardiac monitor, blood pressure cuff, and pulse ox. “I’ll go get Dr. Branston and some warm blankets. Need anything else?”

Meghan looked around. “Got an emesis bag? I’m not too sure at the moment if my stomach is going to stay put or not.”

Bob retrieved one for her and handed it to her. “I’ll see about some Zofran as well,” he promised.

Meghan managed a small smile. “Thanks.”

Bob wasn’t gone but a few minutes when he returned, laden with supplies. “Dr. Branston is in with another patient but will be here soon. I need to get labs drawn and sent off, and let’s get some Zofran on board for that nausea. And here’s a couple of warm blankets.” Bob covered her with the blankets, administered the medication, and drew blood. He was just wrapping up when a knock sounded on the door and in walked Mitch.

“Meghan, you don’t look like you feel that hot.” He smiled reassuringly.

“Understatement of the week,” she replied.

Fred, who was sitting in one of the nearby chairs, chuckled. “Want report, Doc?”

Mitch nodded, his attention on Meghan’s vital signs.

“I woke her up after she’d been gone for more than an hour – I was in the middle of lecture when she headed for the office. She was looking pale and like she wasn’t feeling well. Took vitals, BP was in the high 80s systolic. Gave her her emergency cortisone shot, she called you, started an IV of Normal Saline, and drove her here. She’s complaining of lightheadedness, stomach discomfort and nausea.”

“Have you vomited?” Mitch asked.

Meghan shook her head. “No, but I’m feeling like I could, even with the Zofran.”

“Hmmm. You might have caught the stomach bug that’s going around – seems like it’s hitting folks pretty hard.” Mitch removed his stethoscope from around his neck. “Let me check you out, see what we’ve got going on here.”

Mitch listened to her lungs and heart, felt the glands in her neck. He listened to her stomach, put his stethoscope around his neck again, and placed his hands on her abdomen. “Let me know if anything hurts.” He started palpating her stomach when she threw up… all over him. She grabbed the emesis bag as she threw up again.

Mitch looked down at his scrubs and then up wryly at Fred. Fred wrinkled his nose and laughed. “Well, on that note, I’m heading out. Give me a call with updates, please.”

Meghan wiped her mouth on a clean corner of the now-soiled top blanket. “Yeah, will do,” she answered shakily. She looked at Mitch. “Sorry. Didn’t hurt, though. You might want to go clean up and change.”

“Yeah, I think so! I’ll send Bob in with more Zofran and to help you clean up a bit too. I’ll be right back.” Mitch headed out of her room to get cleaned up.

Bob met him in the hall. “She threw up? Want me to give more Zofran?”

Mitch nodded. “Yeah. She’ll need a new gown and blanket too.”

Bob made shooing motions. “I’ll take care of Meghan. You go get cleaned up.”