To need something done/made in a hurry/in a rush/fast/quickly/immediately/now (i.e., before you do/make anything else).
Used in the food service industry/restaurants/kitchens, typically by food expediters, food runners and/or waitstaff when talking to line cooks (e.g., when a dish is late to come out, waiting for a dish, when a dish needs to be re-made (due to a mistake, dropped, sent to wrong table, etc.)
"Need a another medium burger on the Hee Haw"