Emmy ignores the comment. She paces. 

"...So. What did I miss, earlier. Am I still missing something critical here. - Oh, snap, we should replace potassium too. I'd lean toward getting a NG tube down him and giving him the liquid, so we can give him 40mg in less than four hours, except I dunno what was up with the vomiting earlier, and...probably that's not a great idea when he's still this cold, he won't be absorbing it well. I guess we've got time, that one wasn't a critical result. Pharmacy gave you a max infusion speed for the others?" 

Marian's brain was already overloaded enough and now Emmy is thinking-in-circles out loud and her head hurts. "Yeah. Two and four hours, they're running - together, I checked and I think it's fine and these concentrations. Uh, right, and sure. I can put in the order for that and for the sedation and get that going before we move him? Ugh, I need a cosign on midazolam though..." 

"We really need that central line. Mel, can you bring us a kit once we've moved him? ...Fuck, I don't get it. Why is he this crashy? We deliberately cool people almost this much for the post-arrest protocol and they don't pull this crap. And they're usually old with janky hearts, he's young and - well, look at him, he's clearly fit."  

Oh are they brainstorming out loud now, is that what's happening. Usually Marian loves doing this sort of thing, especially with Emmy, but right now she can't think because she hasn't had her coffee. 

"Ummm. I mean, sometimes young people have heart problems too? He could have some condition that - makes him less able to handle stress on his heart?" 

Emmy snaps her fingers. "Right. The attending can get a bedside echo just to see - I don't know what I'm doing enough. I...still feel like we're missing something, though. He wasn't improving like I'd expected, that was what I noticed first - his lowest temp was actually still just 'moderate' hypothermia according to the Internet, patients supposedly do fine usually with external rewarming only and we did that and the warmed fluids and it seemed like it just wasn't helping that much..." 

This does seem like important speculation to be doing, even if it's a little late for it, but also Marian is too tired and un-caffeinated to multitask, and so she hasn't put in orders for sedation or potassium yet, and minutes are ticking by. 

     "Marian? I pulled the midaz for you - cosign?" 

Marian could hug Amélie right now. "Thank you!" 

Ma'ar isn't awake. Or asleep. For a time, he isn't anywhere. 

...And then he's somewhere, again, just - far away, floating. 

There are voices, fading in and out. And then movement. Discomfort, but not really pain. 

He's so very tired, and the girl he at least provisionally trusts a little said he needed to sleep, which makes sense because he's so tired - and she's still there, he feels the glow of her mind, so far what she said would happen hasn't been falsified (yet).

For now, he succumbs to the inevitable, and sleeps. 

They get him moved across into the bed, and Marian runs off to collect all the spare pillows she can find and get him tucked in, he's been flat on his back for - well, presumably ever since she arrived at the hospital with him in the ambulance - and some vague tickle of a thing she read once informs her that hypothermia increases the risk of bedsores. Which checks out, less perfusion to the skin, whatever. They need him in an appropriate position for central line placement, so she doesn't turn him very far, but she tucks one of the flatter pillows under one side, arranging it so that she can turn him further on her own later. The upside of being down the side hallway like this is that it's quieter; the downside is that helping hands are a lot harder to come by. 

And then Anne-Marie is finally back, wheeling the Bair Hugger machine along by kicking it because her hands are full. Which also shows why she took so long; she's carrying an entire tray of Tim Hortons coffees. 

"Marian? You want black, no?" 

"Anne-Marie I love you," Marian says, with force. "Thank you so much." 

The phone rings. She answers it. 

"...Uh. Uh. Wow. Just a sec, I need paper..."

Where the hell is her clipboard. Oh right she doesn't have it, because unlike her stethoscope, she took it home in her backpack last night. Which is now in her apartment. She doesn't have a single thing written down right now. She doesn't have a pen on her. 

It's hard to have too many regrets, though, because if she hadn't been irresponsibly walking home from a party alone in the early hours of the morning, this guy might be dead on a park bench by now. 

"God, what is it now?" Emmy offers Marian her own pen. 

"Blood gas results, from before." Marian, hunched over the unused bedside table, finishes scribbling a vertical row of numbers on the napkin that came with her coffee. "Not pretty. pH is 7.12." Alarmingly below the normal reference range of 7.35 to 7.45, which by this point Marian just has memorized. "Partial pressure of O2 is 59, that's...low but honestly could be worse. I guess we were ventilating him by then. PaCO2 is...54? That's high but could be worse. Probably was before we tubed him. Bicarb is, holyfuck, it's 13. I hate this blood gas." 

"It's not a great blood gas! Let's get a repeat - god, we should just drop an art line in him at this point, shouldn't we, we're going to be doing a fuckton of repeat labs until his lytes are stable."

Emmy takes a breath. "And I can do that. I'd rather wait for Dr Prissan before I risk a central line, I - I still don't feel confident I can keep the guidewire from going in too far, and if I send him into an arrhythmia right now I'm worried he won't come out of it." 

Marian lets out her breath in a puff of relief, though she remembers to do it quietly. This is one of many reasons she likes Dr Beckett. She's not a cowboy, like half the residents - okay, fine, mostly the male half of them - who would jump on the chance to put in a line unsupervised.

"Right. Want me to get you the kit?" 

     "I'll get it," Anne-Marie offers. "You stay here. Do you need anything else?" 

Marian glances around. "...Could you grab me a spare clipboard. Dr Beckett, uh, do you need your pen back or can I...?" 

"Nah, keep it." Emmy leans on the foot of the patient's bed, hands wrapped around her own coffee. Her eyes focus on the respiratory therapist poking at ventilator settings. "...Uh, set the volumes lower. I was probably overventilating him for a while, I bet we've driven his CO2 way down by now, and - hypothermic, right, lower metabolism, he won't be producing as much. Don't think we need to compensate that hard for the metabolic acidosis. Though we should get a lactate ASAP once I've got the art line in - did we get one before? I can't remember if I ordered it..." 

The room does not currently possess a computer-on-wheels and it's feeling kind of crowded anyway. Marian opens the blinds on the window, then risks ducking out to use the desk outside, so she can actually log in and assign herself the patient and orient better to what happened while she was asleep. 

...Thirty seconds of looking around aimlessly, and she's already thinking that she is very unimpressed. She handed this guy off to them and they NEGLECTED him. She's so offended. ...Probably she's mostly fuming about this because she had less than four hours of sleep and keeps forgetting to actually drink her coffee. 

She takes a large gulp and burns her mouth. 

Emmy glares at the monitor while she sets up her arterial line sterile field and starts draping and prepping the patient's arm. ...Which requires untying his restraint. 

The patient's temperature is reading 31.4. 

"Ugh, we lost almost half a degree just from not having the blanket on him for five minutes? Oh, and Marian, can you come in here a minute and be ready to grab him if he moves? I had to untie him to get at the radial artery." 

Damn. Marian takes another long swig of coffee; at this point she's already burnt all her taste buds, it won't make it any worse. "Uh, if I have to make a grab at him I'll wreck your sterile field? Maybe I can glove up too and I'll...hold onto his hand under the drapes? I can keep his wrist at a good angle for you and it'll be easier to calm him down if he starts waking up when you stick him." 

Emmy shakes her head. "Knowing my luck, he'll wake up and try to punch me in the face." 

She should not giggle that's incredibly inappropriate. Marian makes faces for a few seconds instead. "...Is there a story there?" 

"Oh, just, I wanted a continuous temp on him, but he had some objections to the rectal probe. Patricia got a black eye." 

Probably this wouldn't be hysterically funny on a normal amount of sleep. Or if Marian were less of a terrible person. She snorts despite herself. "You're serious? Wow. ...I mean, if you surprise rectal probed me, I might do that too." 

"...You know, good point. He was pretty out of it and I don't think he understands French or English? For all I know he thinks he's been kidnapped by aliens for their experiments." 

"What? No, I mean, I don't think he speaks English but I'm pretty sure he understands some?"

Oh. Right. It's very possible this information got entirely lost. Marian isn't delighted about disclosing her sleep choices, but. "...Uh, for context, I found him last night. I was walking home. ...I might not've been all the way sober. I was trying to find out if he had a friend I could call or something," maybe she'll just...leave out...the incredibly sketchy-sounding motel room plan that tipsy-her hatched, "and then some skeevy night security guard dude showed up and - I guess thought he was molesting me? So he picked a dumb fight and then...stuff. And then I got a ride in the ambulance and slept over in the ICU." 

Emmy, to Marian's eternal gratitude, doesn't roll her eyes even a little. "Wow! So you've actually got a bunch more info on him. Oh! And maybe that's why you can get him to calm down, if he recognizes you?"