"...He doesn't look good," Bert agrees, lowering his voice. "I - think that's - god - I guess this is for real, isn't it?" 

"Mmm-hmm." Marian doesn't really know what else to say. "Ma'ar, are you– shit! Shitshitshit - Bert can you get someone - Ma'ar! Ma'ar!" 

The run of very fast V-tach finally snaps back after at least ten beats. At which point it falls into a rhythm of one normal-ish beat followed by an ectopic beat or couplet, alternating.

Ma'ar is staring fixedly ahead. It's hard to tell if he's conscious, or tracking them at all. 

"Ma'ar! Hey!" She digs her nails into his palm. "I need you to stay with me." 

He blinks, looking very dazed. Grunts something unintelligible. 

Bert is looking frantically around the room. "I - sorry - I'm not the most useful help right now–" He catches himself. Takes a breath. "What do you need?" 

Marian has no idea! What she really needs is for Ma'ar to not be trying to die on her! 

"I. Uh. We should - probably be ready to intubate him urgently? Where's Dr Z? - Shit he's doing it again–" 

This time, the run of V-tach doesn't stop after ten beats. Or twenty. It's running very fast - at least 300bpm, probably - it probably hasn't been ten seconds yet but it's taking up half the monitor screen already. 

The blood pressure tracing on his art line is still showing spikes - well, bumps - but the curve is dropping very very fast. Ma'ar looks alarmed for a couple of seconds, starts to lift a hand...and then his arm sags back down to the bed, almost in slow motion, as his eyes go unfocused. 

"Ma'ar - MA'AR - fuck, fuck today seriously -"

Deep breath.

"Albert, get clear, I'm going to–" 

The defibrillator makes its horrible obnoxious whining noise as it charges. 

"Are you -" Marian breaks off because Albert is clearly at least six strides back from the bed, and rams the 'shock' button just as the door bangs open to admit Dr Zee and a frantic-looking Nellie. 

Ma'ar jerks on the bed, arms clenching so his fists go to his chest. He takes a couple of fish-gasps, then moans and squirms a little, not very purposefully or effectively. 

The ECG tracing is back in a mostly-normal rhythm. For the moment at least. 

Dr Zee storms to the bedside. "What happened." 

Damn it why is her body picking now to start shaking. Marian is fumbling to check for a pulse, though the art line tracing is reassuring on its own. Sort of. The monitor is having a bit of a time recalibrating itself to give actual numbers, but that's a pulse-shaped waveform for sure. 

"Uh, sustained V-tach. I'd - have to have someone print the strip to know how long - probably ten, fifteen seconds? He wasn't breaking out of it so I shocked him, and..." Vague gesture in Ma'ar's general direction. 

"God. I - at least he held out until now– Bert, get out, please. We've all been exposed, you haven't. Out! ...And grab us some extra hands, please, it'd be poor form to hit the code now but we sure do need some help in here. Nellie, we're going to push a gram of mag and run an amio bolus - get 150mg in a bag, please, fast. And prep a syringe to push if he codes before that's in. Marian, do we still have any pressors hooked up? I want him back on the norepi ASAP - I want to tube him again and he'll tank his BP with any sedation right now." 

"On it." And hopefully she isn't literally too tired to draw up meds safely. 

"I'll get on - other preparations," Bert says, backing hastily out of the room. 

"Marian, is he responsive?" 

"Not...really?" Ma'ar is moaning in a not-especially-communicative way and very ineffectively trying to swat her hand away from where she's currently causing him a lot of pain to try to rouse him at all. He's not opening his eyes for her but he is scrunching them shut against the light, which is slightly better than 'no response at all'. "GCS is, uh, like eight or nine?" 

"Why don't we have a sat reading? Is he not perfusing well?" 

"Uh." Marian has no idea. "I guess. We can try to track down the peds kind and put it on his ear or something again?" 

"Just get a stat blood gas and we'll prep to intubate him. Damn it, we really need more hands in here." 

"I'll pull up drugs - what do you want for it, the usual?" 

"Not propofol for this, no, he's already shocky and I don't want to bottom out his BP any more. Grab some midaz and fentanyl, please? And have some rocuronium on standby, but we probably don't need to paralyze him for it– Goddammit!" 

Marian is busy shlorping a blood gas sample out of the arterial line, and it takes her two seconds to actually get her eyes on the monitor, by which point Nellie is already shoving her out of the way and reaching for the defib 'charge' button. Yup, that's V-tach again and it's not stopping. Aaaaaaaaaaaaaaaah. Why. 

Dr Zee, who's wedged herself at the head of the bed and was fussing with Ma'ar's pillow position, lifts her hands. "I'm clear. Ish." 

"I'm not very reassured by that 'ish'!" Nellie snaps. "Yes or no?"