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

The night the medical affairs department came to conduct their night inspection, the emergency room was unusually quiet.

At 11:30 p.m., Liu Zhenhua walked in with two people. The sound of his leather shoes hitting the floor tiles was clearer than the beeping of the monitor in the corner.

Qin Hai was sitting in his office flipping through medical records when he looked up, showing no surprise whatsoever.

"Director Liu, it's so late."

"A nighttime medical safety check," Liu Zhenhua said with a forced smile. "Won't that disturb your emergency treatment?"

Nurse Zhao rolled her eyes from behind the nurses' station.

They say they won't bother you, but every time they come, they're the ones who cause the most trouble.

Behind Liu Zhenhua, the staff member clutched the record book, first checking the on-duty status of the personnel, then verifying the seal on the ambulance, and then flipping through the consultation registration book.

Turning to the most recent pages, Lin Ye's name appeared so frequently it was almost jarring, causing the clerk to pause several times with his pen.

The ambulance seal was photographed, the temperature of the medical refrigerator was recorded, and even whether any signatures were missing from the night consultation registration book was circled in red pen.

Nurse Zhao muttered in a low voice, "They're investigating even more thoroughly than when we were trying to kidnap someone."

Sun Zhiqiang didn't dare to reply, but only gestured to her with his eyes to shut up.

Liu Zhenhua didn't come alone tonight; he was followed by people from the Department of Science and Education and the Nursing Department, clearly indicating that he wasn't just making a casual appearance.

"Is Lin Ye there?"

Lin Ye had just come out of the emergency room: "Here."

Liu Zhenhua glanced at him: "What are you in charge of tonight?"

"I was taught by Teacher Sun Zhiqiang when I was assisting with the emergency response at the front desk."

Sun Zhiqiang immediately stepped forward: "I was there the whole time."

Liu Zhenhua nodded: "Very good. The principle that resident physicians should not make high-risk decisions alone should be kept in mind by the emergency department."

Though the words were spoken politely, they sounded like a cold nail driven into the ears of everyone present.

Qin Hai didn't reply, but only asked, "Finished the investigation?"

"We also need to check the consultation process." Liu Zhenhua flipped through the register. "Recently, cross-departmental consultations have been initiated too frequently, and the heads of various departments have reported an increase in emergency calls late at night. We don't stop people from being saved, but we need to keep clear records of who made the call, who wrote the basis for the consultation, and whether the senior physician was present."

Qin Hai asked calmly, "Are the department heads reporting more phone calls or more patients they've saved?"

Liu Zhenhua looked up and stared at him.

Qin Hai continued, "The emergency room also wants to make fewer phone calls. If patients all develop symptoms according to the textbook, I'll be the first to tell Lin Ye to turn off his phone and go to sleep."

Sun Zhiqiang coughed lightly, forcing back his laughter.

No sooner had the words left his mouth than the piercing screech of an ambulance brakes suddenly came from outside the emergency room.

The 120-square-meter wagon was quickly pushed in.

The man in his thirties lay in the car, his face bluish-purple, his right chest heaving noticeably weaker than his left, and his breathing sounded as if something was tightly choking him.

The paramedics pushed the patient while shouting, "Car accident injury, chest tightness, shortness of breath, blood pressure dropped on the way!"

Liu Zhenhua hadn't closed the registration book in his hand yet.

Qin Hai had already stood up: "Into the emergency room!"

Lin Ye quickly followed.

The man's name is Zhao Qiang. He is a truck driver. He was rear-ended on the road, and his chest slammed hard against the steering wheel.

His wife, who had accompanied him, had tears streaming down her face and was still clutching the traffic police's accident report in her hand.

"Doctor, he was able to talk just now, why is he breathing so heavily now?"

The paramedics quickly relayed the information: "Seatbelt injury, steering wheel impact to the chest, conscious at the scene, breathing difficulties worsened during transport, blood pressure dropped from 110 to just over 80, and blood oxygen saturation continued to decline."

Qin Haibian glanced at Liu Zhenhua as he listened: "Write down the handover time."

The staff member behind Liu Zhenhua subconsciously picked up a pen, but only realized after writing two words that he wasn't there to help with emergency room resuscitation records.

Nurse Zhao cut open the patient's shirt, revealing a large abrasion injury on his right chest.

Sun Zhiqiang listened with a stethoscope, and his expression changed instantly: "The breath sounds on the right side are almost gone."

Lin Ye stared at the patient's swollen jugular veins and the constantly dropping blood oxygen levels, and then a faint blue system message popped up in his field of vision.

[Emergency room alert activated.]

Patient: Zhao Qiang, male, 36 years old.

Symptoms: Chest pain following a car accident.

High-risk condition: Tension pneumothorax.

[Probability of misdiagnosis: 69%]

[Key abnormalities: progressive dyspnea, jugular venous distension, significantly diminished breath sounds on the right side, and persistently low blood pressure.]

[Loop collapse countdown: 08 minutes 42 seconds.]

Lin Ye's heart sank suddenly.

Eight minutes.

There's no time to wait for a CT scan to confirm the diagnosis.

Sun Zhiqiang has already made his judgment: "Tension pneumothorax is highly likely."

Liu Zhenhua stood at the door of the emergency room, his face serious: "Who needs to operate the equipment? Is a senior physician present?"

His pen tip was still pressed against the notebook.

But right now, every second feels incredibly long, and we can't afford to waste any more time.

Qin Hai had already put on sterile gloves: "I'm here."

Zhao Qiang suddenly began to struggle violently, and his blood oxygen saturation continued to drop.

His wife cried her heart out: "Old Zhao! Old Zhao, wake up!"

Lin Ye grabbed the thoracentesis kit next to him and handed it to Qin Hai.

"Decompress the pressure at the anterior axillary line of the fourth and fifth intercostal spaces on the right side first."

As soon as he spoke, he noticed Liu Zhenhua standing at the door staring at him, and Jiang Peng's pen was also stuck on the emergency record sheet.

If these words were recorded separately, it would sound like a resident physician giving medical advice to a superior.

But Zhao Qiang's lips had turned a dark purple, and his chest was heaving in an eerie way.

Lin Ye shoved the puncture kit into Qin Hai's hand without saying another word.

Liu Zhenhua frowned: "Lin Ye, mind your place."

Qin Hai glanced back at him, his tone turning cold: "Director Liu, he's handing out bags, not acting as director."

The emergency room fell silent instantly.

Zhao Qiang's monitor suddenly emitted a sharp alarm, and his blood pressure dropped again.

Qin Hai didn't waste any more words; he located the needle, disinfected it, and inserted it.

Nurse Zhao stopped Zhao Qiang's wife from behind, saying, "Don't touch the sterile area, stand here and watch."

The woman's eyes were fixed on the puncture needle in Qin Hai's hand. Her lips trembled so much that she couldn't speak. The accident report she was clutching was limp and soaked with sweat, with the corners of the paper drooping down.

The moment the needle pierced through, a burst of high-pressure gas shot out, emitting a short hissing sound.

Zhao Qiang's chest gradually returned to normal, and his blood oxygen saturation soared.

The wife covered her mouth, her legs went weak, and she knelt on the ground, crying.

Liu Zhenhua stood at the door, the registration book still open, but the pen in his hand was frozen in mid-air.

Lin Ye watched as the countdown in his field of vision completely disappeared.

The patient has entered the effective treatment process.

Qin Hai secured the puncture needle and turned to look at Liu Zhenhua.

"Director Liu, shall we continue investigating the procedures?"