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

"2.6".

Xu Qing gave the numbers and said that she had already taken the glucose injection solution out of the first aid kit.

Dr. Han supported Wu Yongfu's chin with one hand to confirm that there was no food or secretions in his mouth, and gently patted his shoulder with the other hand.

"Wu Yongfu, open your eyes."

The old man's eyelids twitched, and he made a muffled response.

"The intravenous access is clear." Xu Qing checked by drawing blood and then connected the syringe. "Start administering."

The ambulance drove over the speed bump, and the carriage bounced up.

Lin Ye grabbed the bed rail to steady himself, then secured the old man's right arm to the soft pad to prevent the needle from being pulled.

Ma Hao sat down at the recording station and announced the time: "5:41 PM, blood sugar 2.6, decreased consciousness and responsiveness."

"Report the vital signs again," Dr. Han said.

The cuff was inflated again.

After administering the medication, Xu Qing looked up at the monitor: "Blood pressure 108/62, heart rate 101, respiratory rate 18 breaths per minute, blood oxygen 96."

Lin Ye continued to observe the elderly man's breathing and the reactions of both sides of his limbs.

Wu Yongfu was able to shake hands as required, releasing his right hand halfway through the handshake and doing the same with his left hand.

The two sides of the face are basically symmetrical, and there is no new vomiting or convulsions.

"Receive the hospital's advance notice." Dr. Han glanced at Lin Ye. "The emergency room at the First Municipal Hospital. The work phone is on the equipment rack. You report it."

Lin Ye removed the telephone that was fixed to the car wall.

Before the call was connected, he first looked at Ma Hao's notepad.

The elderly person's name, age, situation at the scene, blood sugar level, and family member's phone number have been written on the document.

The phone rang twice before the other end answered: "Emergency Department of the First Municipal Hospital."

"This is Emergency Medical Center ambulance number one, bringing in a 73-year-old male patient with hypoglycemia. The patient lives alone, and a neighbor found him collapsed at home. He can be woken up at the scene and says he didn't eat breakfast. There is metformin, glimepiride, and two other unidentified medications in the house..."

"Wait a minute," the doctor who answered the phone interrupted him. "How is the patient's level of consciousness?"

Lin Ye looked at the stretcher.

Wu Yongfu can now open his eyes and will turn his head when called by his name, but his responses are still incomplete.

"Currently, he can open his eyes and respond to being called, but he cannot give a complete answer."

"Vital signs."

"Blood pressure 108/62, heart rate 101, respiratory rate 18 breaths per minute, blood oxygen 96. Blood sugar dropped to 2.6 during the trip, and intravenous glucose has been administered. We are waiting for a retest."

"What was done, and how did it go?"

Xu Qing has just completed the betting process.

Dr. Han indicated that the test would be repeated in five minutes.

"Her blood sugar was 3.1 at the time, and rose to 4.2 after taking oral glucose gel. Her orientation did not recover. Her consciousness and responsiveness decreased after getting into the car, and the blood sugar was 2.6 on the second test."

"How long will it take?"

Lin Ye looked up at the window in front of him.

The driver held up one hand and made a six.

"Estimated time: six minutes."

The doctor on the other end then asked, "Is there hemiplegia, convulsions, or any clear external injury?"

"The physical examination revealed no obvious unilateral weakness, no convulsions, and no obvious injuries to the head or face. The exact timing of the event and any possible medication use are still being verified."

"Send him to the emergency area. Take him directly to bed number two upon arrival at the door. If he is lowered or his consciousness changes en route, call back in advance."

After hanging up the phone, Lin Ye put the receiver back into its slot.

Dr. Han didn't comment on the forecast, but added, "Put the medical history later, report how the person is doing now first."

Ma Hao's work phone was still connected to the old man's son.

He turned down the speakerphone volume and rechecked the phone call from that morning.

When you contacted him at 9:30, did he say he had already taken his medication, or was he about to take it?

He said he had taken his medicine and was preparing to heat up his meal. I told him not to take it on an empty stomach again.

"The neighbor only spoke to him twice at noon, so we can't confirm whether he was conscious or not at that time. Let's take the phone call at 9:30 as the starting point; he was speaking normally then." Ma Hao paused for a moment. "He may have taken glimepiride repeatedly, and we can't confirm the exact number of tablets. The medicine box is already in the car; please go directly to the emergency room at the First Municipal Hospital."

The old man's son repeatedly agreed on the phone and then asked if his father was awake.

Ma Hao looked at the stretcher.

"You've opened your eyes again. The ambulance will arrive in a few minutes. Your condition may fluctuate; the attending physician will tell you more when you get to the hospital."

Xu Qing's blood sugar was retested: "5.8".

Wu Yongfu frowned and pulled his hand back from beside the lancet: "Don't prick me."

"Do you know where you are?" Dr. Han asked.

The old man looked at the roof of the car and the people around him.

"ambulance."

Why are you getting on the bus?

"Low blood sugar".

"What time is it now?"

Wu Yongfu couldn't see his phone and paused for a moment before saying, "It's evening."

"Your answer is more complete than before." Lin Ye reported the changes: "Your grip strength is consistent on both sides, and your face is symmetrical."

Ma Hao added the retest values ​​and reaction recovery time to the record board.

The ambulance turned into the passageway of the First Municipal Hospital, and Lin Ye saw the familiar emergency entrance through the glass of the back door.

The on-duty nurse had already pushed the emergency bed to the door. Before the ambulance had even come to a complete stop, the people outside made way for the transfer.

"A 73-year-old male, living alone, was found collapsed by his neighbor."

Dr. Han stood on the left side of the stretcher, pushing it as he completed the first round of handover.

"His blood sugar was 3.1 at the scene, rising to 4.2 after oral glucose administration, and his orientation remained abnormal. His consciousness decreased en route, with his blood sugar dropping to 2.6. After intravenous glucose administration, it was retested at 5.8, and his consciousness improved. He is suspected of having taken sulfonylureas repeatedly, but the dosage is unclear. The last confirmed normal time was 9:30 AM. A neighbor spoke to him briefly around 12:00 PM, but it's uncertain whether he was fully conscious at that time. There were no obvious convulsions or external injuries. His family is on their way."

The attending physician stood by the bedside, first checking the monitoring and intravenous access: "Did you bring the medication?"

Xu Qing handed over the transparent bag.

"We brought all the medicines on the table, including glimepiride. We haven't confirmed the two strips of powdered medicine yet."

"Okay. Move to bed number two, monitor blood glucose continuously, and complete the necessary examinations."

Wu Yongfu was moved onto a resuscitation bed.

The nurse connected the monitor to the hospital and the blood pressure reading was not much different from that in the car.

The attending physician re-examined the pupils, face, and limbs, and asked for the name, location, and time again.

The elderly man was able to say that he was at the First Municipal Hospital, but he still got the specific date wrong.

Lin Ye added the location of the medicine plate found at the scene, the two newly broken holes in the aluminum foil, and the elderly man's statement that he took the medicine on an empty stomach to the handover.

The attending physician looked through the medication box, then looked up and asked, "After your blood sugar was first corrected, how long did it take for it to drop again to its lowest level?"

Ma Hao checked the record: "At the scene, 4:20 is 5:27 PM, and in the car, 2:60 is 5:41 PM, a difference of fourteen minutes."

"This time should be recorded in the medical record."

The attending physician placed the medicine bag at the bedside.

"Sulfonylurea-related hypoglycemia can recur, so we can't just let people go after one visit. When family members arrive, don't rush to sign the discharge papers."

Dr. Han completed the signing and handed the pre-hospital record to the attending physician.

Lin Ye stepped back to the foot of the bed and looked at the familiar emergency bed from the other side of the stretcher for the first time.

After the patient handover was completed, the four people returned to the ambulance.

Xu Qing replenished the supplies, and Ma Hao followed to check the used glucose and blood collection needles.

Lin Ye wiped and disinfected the bed rails. Just as he put down the rag, the dispatcher asked again how long it would take for vehicle number one to return to standby status.

Dr. Han replied, "Five minutes," and asked the two to go through the dispatch log from the beginning.

Ma Hao handed the recorder to Lin Ye: "In your phone call, you spent more than twenty seconds talking about the patient's medical history, but they didn't take notes on a single word. They asked you first if the patient was awake."

"I heard you."

"I thought you could finish reporting it all at once."

"When you come to report, you'll first mention living alone and the medicine box."

Ma Hao pulled the pen off the clip: "Next time it's my turn to report."

It was nearly 7 p.m. when we got back to the emergency center.

The phone in the dispatch hall rang incessantly, and the vehicle status on the wall kept changing.

With the first vehicle put on standby, Dr. Han took the two back to the recording room.

Lin Ye found a blank sheet of paper and wrote four lines: Current consciousness, vital signs, treatment already taken, expected arrival.

He added "Last normal time", "Main risks", "Medications and dosages" and "Family contact information" below, and crossed out the two duplicate items.

Dr. Han walked past him, picked up the paper, and looked at it.

"The order this time is much better than in the afternoon."

Lin Ye waited for the second half of the sentence.

Dr. Han touched the top with the tip of his pen.

"But you haven't written why you sent him to this hospital."

"The patient requires continuous monitoring and further treatment. The First Municipal Hospital has the capacity to receive them and can arrive in time given the current road conditions."

"Today is suitable. But if I need to treat trauma, stroke, or chest pain tomorrow, is the nearest hospital the best option?"

Lin Ye did not answer.

Dr. Han put the paper back on the table: "Don't rush to set the schedule. Let's go back for another check-up tomorrow."

(Taking a day off... I'm too busy, I'll update more tomorrow!)