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

On the second day of his day shift, Lin Ye had just changed his clothes when the triage nurse approached him with a report from the emergency center.

"There's a driver with a hand injury. We'll be there in five minutes. He's 31 years old. His right palm was cut by glass. The wound was already bandaged and the bleeding stopped before we arrived at the hospital. He's conscious and his vital signs are stable."

Lin Ye took the record: "How's the finger movement?"

"Both fingers are mobile, but the ring finger flexes a little slower. The extremities are normal in color. The patient says they feel a little numb, but the exact area wasn't determined before the hospital visit."

"Take him to the treatment area first, don't occupy the resuscitation bed. Keep his right hand elevated before hospitalization, and don't remove the dressing."

The triage nurse went back to report to the emergency center.

Lin Ye wrote the forecast on the vehicle receiving board and instructed the treatment area to prepare rinsing supplies, sterile dressings, and local anesthetic items.

Zhou Min passed by the emergency room and asked about the injuries.

"Vital signs are stable, but there is a glass fracture in the palm, and the ring finger is moving a little slowly. I will check the blood vessels, sensation, and tendons first, and then decide whether I can proceed with treatment directly."

"Call me if you need specialist coordination."

When the ambulance arrived at the hospital, Jiang Chen got out of the vehicle by himself.

His right hand was wrapped in a thick dressing, his arm was raised in front of his chest, and there were a few drops of dried blood on the cuff of his work clothes.

He was still holding his phone in his left hand, and messages from the construction site group kept popping up on the screen.

"Doctor, how many stitches will it take?"

He sat down by the treatment bed, and the first thing he asked was the time.

"The cabinet doors over there aren't finished being installed yet; I have to go back this afternoon."

Jiang Chen raised his hand, which was wrapped in a dressing.

"The bleeding has stopped, so it must be a superficial wound, right?"

"First, check if there is any damage inside the wound."

Lin Ye gestured for him to put his phone down.

"How did you cut the glass?"

"When installing the shower enclosure, a piece of the glass chipped off the edge. I pulled my hand back and it slid past it."

"Was the glass broken? Is it possible for shards to remain in the wound?"

"It's cracked, but not completely shattered. I can't really say for sure."

Lin Ye then asked about her allergy history, long-term medication use, and tetanus vaccination.

Jiang Chen doesn't usually take anticoagulants, doesn't have diabetes, and can't remember when he got his tetanus shot.

"The construction site clinic only used iodine solution on me, does that count?"

"Not considered vaccination."

Lin Ye asked the nurse at his bedside to check his past records.

"I can't remember the vaccination date, so I'll give you a booster shot first. The amount of immunoglobulin needed will depend on the wound's level of contamination and whether the full course of vaccinations was completed previously. This will be confirmed when the hand surgeon treats the wound."

The nurse at the bedside confirmed that he hadn't taken off the ring on his right hand, so she removed it, put it in a small bag, and handed it to him.

The dressings were peeled off layer by layer before the hospital visit, revealing a diagonal wound about three centimeters long on the palm near the base of the ring finger.

There wasn't much bleeding, and the surrounding area was stained with congealed blood.

Lin Ye first touched the radial and ulnar arteries, then pressed several fingertips to confirm that the color had returned.

Then, Jiang Chen was asked to close his eyes, and cotton swabs were used to touch both sides of the ring finger, and then compared with the adjacent fingers and the left hand.

"Can you feel it from here?"

"Yes, it's a little blunter than the other side."

Jiang Chen pointed out that the location of the hair is close to the palm side of the ring finger.

Lin Ye recorded the scope in the emergency room record, preparing to hand it over to the hand surgery department as well.

"Clench your fist now."

Jiang Chen tucked his five fingers together.

The movement was indeed performed, though the ring finger was a beat slow, but it still touched the palm in the end.

"Look, it can move. The tendons inside must not be broken, right?"

"The fact that it can move only means it's not completely broken." Lin Ye held his right hand. "Don't use force yet, I need to check each strand one by one."

He kept his index, middle, and little fingers in a straight position, only allowing the ring finger to bend at the proximal interphalangeal joint: "Bend here first."

Jiang Chen did as instructed, but with a smaller range of motion than with her left hand.

Lin Ye then fixed the middle joint of his ring finger: "Now just move your fingertips, hook them towards your palm, and then hold my hand in place."

The pressure loosened as soon as the fingertips pressed down.

"It hurts so much inside the wound."

Jiang Chen took a breath.

"Switch to your left hand."

The left ring finger held the resistance but didn't move, while the right ring finger was pushed back to its original position twice.

Jiang Chen looked down at his hands and didn't urge them to get stitches.

"Is it because you're in pain that you're weak?"

"Pain may affect the ability to exert force, and partial tendon damage cannot be ruled out. Even with partial damage, the fingers may still be able to move. If there is no resistance, you should be wary."

"So what do we do next?"

My phone vibrated again.

Jiang Chen answered the call with his left hand. The person on the other end of the construction site first asked him when he would be back, and then asked if the hospital could issue a certificate.

Jiang Chen stared at his bandaged right hand, only saying that it was still being checked, and didn't dare to ask any further questions about how his wages would be calculated for today.

After hanging up the phone, he put it on his lap.

"We're paid by the day. I can't use my right hand properly, and no one's collecting the rest of the work today. I don't know if this trip counts as a work injury."

"I will record the time, place, and severity of the injury in the logbook. The diagnosis certificate will be issued according to the hospital's procedures. Whether it counts as a work-related injury is not determined by the emergency room; it requires the employer's reporting and verification process."

Lin Ye placed both hands side by side in front of him.

"Try it again yourself. Hold the glass with your left hand and don't move it, then apply force with your right hand and it will come back. Go back and continue lifting the glass today. If there are any fragments in the wound, or if the tendons are partially injured, the problem will only become more complicated."

Jiang Chen tried to bend his right ring finger alone, and halfway through the movement, a layer of fine sweat appeared on his forehead.

The bedside nurse covered the wound with a sterile dressing, secured his hand, and reminded him not to try again.

"Take an X-ray first to see if there are any clear glass foreign objects or bone damage." Lin Ye handed the examination request to the nurse. "Stop the routine suturing for now and ask the hand surgeon to come over."

"Are you looking for a hand surgeon?"

"Yes. We need to find out the truth now so we can know how to handle it later."

While waiting for the video, the construction site called again to ask what to do with the remaining cabinet doors.

Jiang Chen paused for a moment, then changed his mind and said, "First, find someone to cordon off the area and don't touch that piece of glass again. Take a clear picture of where the glass is broken, and also of what's on the ground."

The photos arrived quickly.

The edges and corners were uneven and missing, and several small pieces were scattered on the mat.

Lin Ye told him to keep the photos safe: "Show them to the hand surgeon when he comes over, and explain clearly how the glass cracked when he was injured."

After the imaging was completed, Jiang Chen saw "no obvious fractures found" on the report.

"The X-ray didn't show any glass, so does that mean it can be sewn up?"

Lin Ye put the film back in the lightbox.

"The X-ray didn't show a fracture or a clear glass foreign object, but very small fragments could still be missed. The ring finger still has abnormal sensation and strength, so we can't suture it directly based on this X-ray."

When the hand surgeon arrived at the treatment area, Jiang Chen had already muted the construction site chat.

He re-examined the location and sensation of the wound, and repeated the separation, flexion, and resistance movements.

"The strength is definitely wrong, and the sensation is abnormal," the hand surgeon said. "Take him to the hand surgery treatment room for further treatment. Don't close the wound yet. We'll reassess and perform exploration if necessary."

Jiang Chen leaned against the bed and sent a voice message in the construction site group with his left hand.

"I can't go back today. Seal off the site first, and don't move that piece of glass anymore. We'll talk about it after I've finished my inspection."

After successfully sending the message, he stared at the replies popping up on the screen, supporting his right wrist with his left hand, without touching the bandage again.

The bedside nurse administered a tetanus vaccine to Jiang Chen as prescribed by the doctor.

Lin Ye handed the emergency room record to the hand surgeon.

"The patient's previous vaccination history is unknown, and the immunoglobulin levels need to be further evaluated in conjunction with the wound contamination situation. I have written this in the handover document."

"understood."

The hand surgeon took the record.

Jiang Chen followed him to the hand surgery treatment room.

The bedside nurse began changing the disposable items on the treatment bed.

Before Lin Ye could even return to the emergency area, the phone at the triage desk rang again.

The triage nurse answered the call but only listened to a few words before turning to call him.

"Dr. Lin from the emergency room, pre-hospital advance notice."

Lin Ye answered the phone.

"The patient is 29 years old and presented with sudden onset of persistent palpitations. He was conscious and his blood pressure was 118-174. A pre-hospital electrocardiogram showed regular narrow QRS tachycardia with a heart rate of 192..."