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

Before the call was even disconnected, Zhou Min had already emerged from the emergency room.

Lin Ye handed over the referral registration form, his fingertip pointing to the line of numbers he had just memorized.

"The second bag was just put on; the measurement of 104 to 66 has only been taken this time. The person is already being pushed towards the ambulance."

Zhou Min took the receiver.

"I am Zhou Min from the Emergency Department of the First Municipal Hospital. Don't let the patient get in the ambulance yet; take their blood pressure again at the bedside."

Someone answered the phone, followed by, "Stop the flatbed cart for now, and don't remove the monitoring equipment yet."

Zhou Min spread the registration form out next to the workstation and looked down at it: "How is your consciousness now?"

"He is conscious and can answer questions. However, he looks unwell and is constantly sweating."

"What is the blood oxygen level after using an oxygen mask?"

"Ninety-seven percent while receiving oxygen via mask."

Before the doctor could finish speaking, someone nearby reported the blood pressure.

He repeated into the microphone: "Ninety-eight to sixty. Heart rate one hundred and twenty-one."

Lin Ye added another line below the previous set of numbers to record the time.

The doctor from the county hospital leaned closer to the microphone and spoke even faster than before: "The ambulance has arrived. We'll continue the blood transfusion and head over there, is that alright? If things go smoothly, it should take about forty minutes."

Who accompanied the ambulance?

"The emergency room doctors and nurses are there. They have monitors and oxygen, and they haven't started administering vasopressors yet, but they can continue transfusing blood."

"How many intravenous access lines are currently available?"

There was no immediate response on the other end of the phone.

Someone shouted that the left forearm was still usable, but another voice chimed in, saying that the right forearm hadn't pulled back properly earlier.

"One line is definitely clear now." The doctor on the other end of the line picked up the microphone again. "I'll start another one, and then you can leave."

"Then let's get the access route sorted out first. Continue the second bag of fluids, and report the blood pressure again every ten minutes. Can the original X-ray films be taken along in the ambulance?"

"We didn't have time to do the CT scan. We have the bedside ultrasound images and pelvic X-rays, which are being copied onto a disc."

Zhou Min raised her hand and beckoned to Jiang Wen.

Jiang Wen walked to the side and covered the microphone with her palm: "Make room for a resuscitation bed, and prepare monitoring and pressure infusion equipment first. Notify the blood transfusion department to prepare blood for the resuscitation, and then contact the general surgery, orthopedics and anesthesiology departments. There is a patient with multiple injuries from a fall at the county hospital, so prepare to transfer him here."

Jiang Wen turned to push the ambulance, and as she passed Lin Ye, she also took the internal phone from the table.

Suddenly, the patient's voice came from the other end of the phone: "Doctor, I'm a little cold."

The doctor at the county hospital had another blanket added, then leaned close to the patient's ear and asked, "Do you still know where you are?"

The patient answered slowly, but got the location and name right.

Zhou Min waited for the second channel to be connected, and the third set of numbers was also reported.

"Ninety-six to fifty-eight. Heart rate 120. Consciousness is the same as before."

"This blood pressure isn't stable yet." Zhou Min glanced at the three sets of values ​​Lin Ye had written down. "But we can't leave him there waiting indefinitely. Continue the blood transfusion, with doctors and nurses accompanying him in the ambulance for continuous monitoring. Report his blood pressure on this phone number when we leave and during the journey. If there are any changes along the way, call back immediately."

"Okay. We'll connect the second passage and depart within five minutes."

"The emergency bed is ready here. Let me know the time as soon as the car leaves."

When the phone was handed back to Lin Ye, the county hospital was checking the blood transfusion bag and the patient's wristband.

Someone stuffed the burned CD into a document bag, the plastic seal brushed against the microphone, and a rustling sound came through the receiver.

At 4:38, the ambulance departed from the county hospital.

Lin Ye wrote the time into the registration form and circled the lowest blood pressure, the three repeat tests, the start time of the second bag of red blood cells, and the accompanying personnel.

Zhou Min picked up her watch and glanced at it, then told him to go and save a patient waiting to be taken to the hospital.

The emergency bed was pushed to the side near the door, and the monitoring cables were spread out on the sheets.

Jiang Wen raised the IV stand to its highest position and then went to check the blood and pressurized infusion equipment needed for emergency treatment.

The general surgery doctor on duty arrived first, followed by the orthopedic surgeon who came downstairs, one of his sleeves still unbuttoned.

The ambulance returned the call twice on the way.

The first time, the patient's blood pressure was 98 to 61, and he was still able to speak.

The second time, ten minutes before leaving the First Municipal Hospital, my blood pressure was 94/56, my heart rate was 123, and my oxygen saturation was 96 with a mask.

The second bag of red blood cells was almost finished being transfused, and the patient did not vomit, nor did his consciousness change.

After listening, Zhou Min reminded the accompanying doctor: "When we arrive, take the patient directly to the first resuscitation bed and don't linger at the door."

At 5:26, the vibration of a stretcher carrying a child crossing the threshold could be heard outside the door.

"Forty-two years old, fell from a height, estimated at about five meters." The accompanying doctor pushed in a stretcher, speaking rapidly, his forehead covered in sweat. "Upon arrival at the county hospital, his blood pressure was as low as 78/46. A bedside ultrasound revealed fluid accumulation in the abdominal cavity, suggesting a pelvic fracture and left thigh deformity. He still has the neck brace, and his pelvis has been stabilized, with a temporary splint on his left leg. He's on oxygen via face mask, and his second bag of red blood cells has just been transfused. During the journey, his blood pressure was as low as 94/56, and he remained conscious throughout."

Lin Ye stood at the head of the bed, took the document bag, first checked the patient's name and wristband information, and then confirmed that the neck brace had not shifted.

Jiang Wen took over the guardianship from the First Municipal Hospital.

The cuff tightened, and the screen displayed 92 to 54, with a heart rate of 124.

The blood transfusion from the blood transfusion department had arrived at the bedside, and Jiang Wen and another nurse were checking it.

Lin Ye looked at the numbers and turned directly to the last page of the registration form: "The lowest ratio at the county hospital was 78 to 46. After the second bag of red blood cells was replaced, it was 104 to 66, 98 to 60, 96 to 58, and the lowest ratio en route was 94 to 56. Upon arrival at the hospital, it was 92 to 54, and it still couldn't be stabilized."

The patient's eyes were open, his lips were pale, but his hands were still clutching the blanket covering him: "I can't move my legs."

He can even answer himself.

Zhou Min bent down to check the mouth and nose, confirming that there was no obvious blood or vomit, and then listened to the breathing sounds on both sides.

"Don't strain your legs, and don't try to turn over on your own." She called his name. "If you can hear me, look at me. Is your stomach or your legs hurting the most right now?"

My stomach feels a little bloated.

The general surgeon had already stood by the bedside and reached out to examine the abdomen.

The orthopedic surgeon examined the location of the pelvic fixation band on the other side and the peripheral blood supply to the left foot.

As the anesthesiologist pushed the equipment in, he overheard Zhou Min reporting that her blood pressure hadn't stabilized.

"Given his current blood pressure, we won't send him for a CT scan yet." The general surgeon straightened up. "I'll call my superiors and report this to the operating room as well."

Zhou Min reported the patient's blood pressure, abdominal symptoms, and bedside ultrasound results from the county hospital to the general surgeon after the patient arrived at the hospital.

The other party continued to examine the abdomen while waiting for a reply from their superiors.

Lin Ye stepped back half a step and handed over the pelvic X-ray disc, bedside ultrasound record, and blood transfusion slip from the file bag to the person who took over.

Once the general surgery supervisor arrived, Zhou Min continued to report on the changes in the patient after he arrived at the hospital.

After verifying the bedside conditions, the other party took the blood transfusion form.

The senior general surgeon stayed by the bedside, the anesthesiologist stayed at the bedside to observe the airway and monitor the patient, and the orthopedic surgeon continued to examine the left leg.

Lin Ye handed the completed phone registration to Zhou Min and returned to the workstation outside.

After explaining the injuries at the bedside and the matters to be handled next, Zhou Min took the registration form and put it back in front of Lin Ye.

"Keep this form safe and bring it with you when you hand over your shift tonight."

Just as Lin Ye was about to put it into the medical record, Zhou Min added another sentence.

"Don't leave after you're done here. Director Qin needs to speak with you."