"Just sedate him please!" Why is there an earthquake this is the worst time in the entire world for there to be ALSO AN EARTHQUAKE, she didn't think Reno was even a high earthquake rate sort of place. 

"I'm trying, he keeps– fuck, is he having a seizure or something–" 

Marian doesn't think so, but even if he is, propofol will stop that too and then they can figure it out when her patient is not stuffed inside a CT scanner. She goes back to frantically programming the pump. 

Within the next ten or fifteen seconds, the patient stops struggling and goes limp - and the floor stops shaking, too. 

Marian sags against the table. "That really could have gone better. Thank you, Emma." 

"You're welcome, should we keep going with the scan now?" 

"Uh, give me a minute to get fresh vitals." Marian whacks the button for another blood pressure reading, and goes back to messing with the O2 sat probe trying to get a reading; it's given up on even made-up numbers and is just showing a question mark.

A pause. 

The monitor dings sadly at her. 

"- BP's down to seventy over forty, crap, I think he doesn't like the propofol - how much did you give him?" 

"Ummm, all of it?" Emma gives her a wide-eyed look. "He's a decent-sized guy and he was getting pretty combative." 

...She is not going to yell at the tiny baby doctor for lacking the common sense to notice that a reasonable dose of sedative for this patient if he were otherwise healthy is NOT the same as a reasonable dose given that he's clearly already in shock and probably bleeding internally or something. Yelling at Emma will not help. 

Also she doesn't have anything on her to address this, because she's an idiot. 

She mashes the refresh button on the blood pressure again. "Okay. We're okay. It's short acting so his BP should come back up soon, but I also want to be able to go up on the drip if I have to and I don't know if he'll handle it. Can you go get me some pressors - norepinephrine, whatever, just something we can have ready–" 

"Right – um, I don't know where..." 

"Go back to the ED if you have to but maybe consider running."

After Emma runs off, Marian has a moment to consider that if her patient codes she is now trapped in the CT room BY HERSELF and this is the worst day ever. If there's another earthquake on top of everything else she is going to cry. 

The radiology tech sticks his head in. "Everything all right?" 

Marian does NOT snap that this is a stupid question. "Just give us a minute," she says shakily. "Sorry." She wants her coffee so badly but she kind of needs both hands free right now. 

The next blood pressure is down to 52/29, and Marian grits her teeth and takes it again. She still can't get a sat reading. Probably because with that BP he barely has circulation going.

"Argh," Marian mutters to herself. She fiddles the ventilator settings up to 100% oxygen just in case. And squeezes the half-deflated bag of saline to make it go faster. It's not like she has anything else she can do. 

The next reading fails to give her anything at all; the poor confused machine just spends thirty seconds whirring before turning up question marks. Marian swears and tries to reach around the backboard head blocks and the hair-caught-in-Velcro to check for a pulse. 

She finds one and is very slightly relieved, and then more relieved when the next blood pressure reading is above 60 systolic, which is not usually cause for celebration BUT. 

By the time Emma gets back, it feels like about a century later, with another one of the ED nurses and an IV pump and bag of pressors, the patient is up to a basically-tolerable blood pressure. Also he's starting to squirm and cough again, but Marian is at this point kind of terrified to up the sedative drip before they arrive. 

Marian transfers the second IV pump to the same pole for simplicity, and finishes priming the tubing and programs the pump and hooks it up. To the same IV, which isn't really recommended for those two drugs together, but there's lots of saline going in to dilute it and probably it'll be fine for five minutes. She does have IV supplies in her pockets but her hands are kind of trembly right now. 

She gives it another couple of minutes of fiddling with dosages, and sets the blood pressure automatic cycle to every three minutes, and then goes back to the glass-walled observation room and retrieves her coffee and flops. 

Probably she didn't calibrate the drips exactly right, because the patient's blood pressure is creeping up kind of high now, but she will TAKE IT and deal with it LATER. 

...Five minutes or so later, the tech whistles through his teeth. 

Marian jerks around, nearly spilling her half-drunk coffee. "What?" 

"Come have a look - this is a pretty spectacular scan, wow - left lung's completely whited out." 

"Oh fuck." Considering that news, she's actually surprising he isn't doing a lot worse. 

Emma-the-resident leans in to look as well, then shares a glance with Marian. "I think we know where he's bleeding now! Should I, uh, call someone - probably we need to get him to the OR...?" 

"Yes. That'd be great. Please do that." Normally Marian would offer slightly more in the way of handholding, for a tiny baby doctor clearly out of her depth, but she is so done with this situation.

She digs out her own phone and tries to call Alice, and very unsurprisingly doesn't get an answer, so she dials the main phone for pod one instead. And checks the time again while it rings. God, how is it already past eight... She needs to pee too. Which cannot happen now. 

Elaine answers. "Yes? Oh, Marian, is that you - what's keeping you?" 

"Adventures," Marian says drily. "Can you check that room 113 is ready for us? New admit's got a horrific hemothorax, probably got to rush him to the OR, but I want to not be in CT one second longer." 

"...Got it. Uh, do you want me to give your leg lady her meds too? Oh, and Alice wants to know if you can take this admit after all, she's probably taking over the patient in 110."