When I'm on the night shift, all the department heads can't sleep.

The negative pressure ambulance is expected to arrive in twenty minutes.

Xu Wenliang's transfer handover form and vehicle passage information were successively transmitted to the administration building.

The vehicle, personnel, and route have been filled out, and the vital signs section of the handover form states that the blood oxygen saturation is 94 percent.

The scanned document was uploaded by the nurse on duty at the fever clinic, and a space for supplementary records is provided at the bottom of the page.

Lin Ye looked down but couldn't find any information about oxygen therapy methods or equipment parameters.

A prompt will then appear at the edge of the field of vision.

[Risk Factor: Mismatch in respiratory support conditions before and after transport]

Key gaps: current high flow rate parameters, oxygen supply methods en route, oxygen reserves, and contingency plans for deterioration.

He turned the handover form to Song Lan: "Writing 94 here isn't enough. Xu Wenliang is currently being maintained by high-flow humidified oxygen therapy, but the form doesn't show what equipment is being used or how much oxygen is needed during the journey."

After reviewing the document, Song Lan immediately contacted the on-call medical staff: "The vehicle route is fine, but the handover form is missing respiratory support equipment. Please have the fever clinic and transport team complete it, and we will register the vehicle and accompanying personnel according to the supplemented plan."

After receiving the missing information, the on-call medical staff immediately contacted the respiratory department, the fever clinic, and the transport doctors in the negative pressure ambulance.

A few minutes later, the supplementary record was sent back.

Xu Wenliang is currently using high-flow humidified oxygen therapy, 50 liters per minute, with an inhaled oxygen concentration of 60%, and his resting blood oxygen saturation is maintained between 92% and 94%, with a respiratory rate of 34 breaths per minute.

The transport team carried a vehicle-mounted high-flow humidified oxygen therapy device, and also had a transport ventilator. Before departure, the main oxygen source, backup oxygen source, battery level, and monitoring equipment had been verified.

Based on the estimated journey distance and current parameters, the oxygen reserve is sufficient to cover the entire journey, with a surplus.

Before boarding the vehicle, the patient is jointly assessed by the respiratory specialist and the transport physician.

If oxygenation drops or consciousness changes during transport, the transport personnel will immediately check the tubing and oxygen source. The transport doctor will then decide whether to upgrade respiratory support and will notify the receiving hospital in advance.

Song Lan added the supplementary pages to the electronic handover record: "Now I can understand where this number ninety-four came from."

Ma Hao checked the electronic data catalog. The blood gas, imaging and medication records were all listed, but the official report from the municipal CDC was still in the hospital's internal testing system.

He contacted the fever clinic to print out the report, checked the number, and only checked the box next to the catalog after the nurse confirmed that it was bagged.

"We need to recreate the hospital records when we get there. If one record is missing, we'll have to go back and chase it up," Ma Hao reminded him over the phone. "After you've finished compiling the paper documents, also report the person who handled them and the sealing time to me."

The nurses at the fever clinic completed the bagging and sealing, and reported the handover person, sealing time, and receiving department back to the administration building.

Ma Hao checked each item one by one and added them to the electronic catalog.

Ma Hao entered the ambulance's license plate number, the names of the accompanying doctor and nurse into the access record, and then checked the hospital's phone number again.

After receiving the route, the access control personnel at the administration building cleared a separate passage for the ambulance from the fever clinic's dedicated exit to the outside of the hospital.

In the isolation ward of the fever clinic, a respiratory physician is reassessing Xu Wenliang at his bedside.

The high-flow nasal cannula is still working.

Xu Wenliang kept his eyes open and could understand what the doctor was saying, but he had to pause to catch his breath after each sentence.

The nurse reattached the ECG monitoring electrodes and checked the intravenous access, test reports, and medications in the ambulance.

The transporting doctor entered the isolation area in advance to review the most recent blood gas and chest imaging.

The equipment on the vehicle was a different model than the bedside equipment. The respiratory physician explained the current parameters, the changes in blood oxygen over the past two hours, and the tendency for the blood oxygen to drop when the vehicle was moved.

After both sides confirmed the switching order, the nurse pushed the spare oxygen source to the bedside.

The pulmonologist leaned down and asked him, "The bed at the designated hospital has been confirmed. You'll be going there in a negative pressure ambulance. Someone will be watching you the whole way, understand?"

Xu Wenliang nodded, and after a few seconds asked, "Does my daughter know?"

"We are contacting them."

Xu Jing's call was answered quickly.

She was still waiting in the designated area of ​​the hospital and could not go with the vehicle. After hearing the transfer arrangements, she first mentioned her father's cell phone, which was in the taxi.

"The phone is still with the driver and can't be delivered right now. My dad's at the new hospital, and he'll be worried if he can't find me."

The doctor at the fever clinic told her, "The receiving hospital has already taken your number. The ward will contact you after you arrive. You don't need to send your phone now. Your ID, past medications, and test results will all be sent with you."

"Please have the driver keep that phone for now," Xu Jing said. "I'll retrieve it when it's cleared here. I don't want him to have to go to the hospital just to deliver the phone."

The staff added this information to the family contact record, and the receiving hospital continued to use Xu Jing and her mother's phone numbers as the primary means of contact.

Xu Jing then asked, "What if he can't catch his breath on the way?"

"The transport doctor will monitor him throughout the process, and the respiratory support and backup oxygen supply in the vehicle have been verified. The reason for arranging the transfer now is that the intensive care facilities at the designated hospital are more suitable for his continued treatment."

Xu Jing responded and recited her mother's number again, only hanging up after confirming that the recipient's registration was correct.

After the negative pressure ambulance arrives, it enters through the dedicated channel for the fever clinic.

The transporting doctor and fever clinic medical staff completed the handover in the passageway, checking the patient's identity, oxygen therapy parameters, most recent blood gas analysis, imaging data, and intravenous access item by item.

Other personnel are temporarily prohibited from passing through both ends of the dedicated passage.

Security personnel checked license plates on the outside of the vehicle, while infection control staff confirmed the protective measures taken by the passengers and their routes of entry and exit.

The regular emergency room entrance was still accepting patients, and another ambulance continued to enter the resuscitation area along the emergency route.

When switching from bedside equipment to transport equipment, the pulmonologist kept his eyes on the monitor.

Xu Wenliang's blood oxygen level briefly dropped to 91%, but returned to 93% after the interface was readjusted.

The transporting doctor confirmed that the monitoring data was stable before allowing the gurney to be pushed onto the vehicle.

Before the car door closed, Xu Wenliang raised his hand. The nurse, unable to hear what he said through the protective face shield, moved closer.

"Tell my daughter not to let her mother come over."

The nurse nodded. After the car door closed, she relayed the message to Xu Jing via her work phone.

At 2:08 PM, the negative pressure ambulance departed from the designated exit. After receiving the departure time, Ma Hao changed Xu Wenliang's status to "transferred to designated hospital," leaving the confirmation section blank.

Fourteen minutes later, the designated hospital called back, saying that the patient had been transferred to the intensive care unit, and the oxygen saturation had not dropped significantly again during the journey. The handover documents were complete. Only then did Ma Hao add the time of receipt and the name of the receiving doctor.

Xu Jing also received a call from the designated hospital ward.

The other party verified the family relationship and two contact numbers, and informed the patient that he had arrived at the hospital, and that the subsequent treatment would be communicated by the ward doctor.

She hung up the phone and immediately sent a message to her mother: Dad has arrived at the designated hospital.

She then remained in the original area to await further instructions.

Gao Limin, Shao Dequan, and Gao Yuan are still waiting for subsequent beds according to their respective conditions.

The medical treatment team continued to arrange the transfer order based on oxygenation, underlying diseases, and bed availability.

After the designated hospital finished registering the return calls, Song Lan glanced at the temporary rotation schedule: "Lin Ye, go back to the next room and lie down for a while. Get up at 4:30 to take the next shift. Ma Hao will stay here; he's already connected with the community line."

Lin Ye was indeed so tired that his eyes were sore. After confirming that Xu Wenliang had been handed over to the receiving hospital, he stopped trying to stay awake.

He registered his departure time at the door and returned to the adjacent lounge.

Ma Hao pulled Cheng Hao's page to his own side and casually took the sampling receipt sent by the local authorities.

Cheng Hao and his mother's samples have been sent to the municipal CDC laboratory. Ma Hao received the receipt and filled in the submission time and sample number in the external investigation column.

Fang Cheng, Liu Chunmei, and Zhao Bo have also completed their first sampling, and none of them currently have a fever or cough.

Several off-site routes are each independently followed up by their respective jurisdictions, and the hospital's list only retains the receipt status.

At 3:46 PM, the municipal CDC laboratory called again.

After Cheng Hao's sample was re-extracted and re-examined, both ORF1ab and N gene targets were clearly amplified. The quality control results were normal, and the official report concluded that the sample was positive for novel coronavirus nucleic acid.

Song Lan checked the report number, and Ma Hao updated Cheng Hao's "fever pending sampling" to a formal positive result.

The municipal CDC immediately adjusted the tracking order for the two events. Those who worked with Cheng Hao, dined with him, or attended both events were prioritized for contact.

After receiving the results, the on-call medical officer added Cheng Hao to the external common exposure chain. The hospital has not yet adjusted the existing access area.

For the first time, staff members involved in the event appeared on the list of positive cases related to the Kangning Hotel.