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

The restructuring plan for the emergency department of the First Municipal Hospital is progressing faster than anyone imagined.

Just three days after that harrowing weekend night shift, in the emergency department doctor's office, Director Qin Hai officially announced the establishment of the "Rapid Response Team (RRT) for Critical Care".

There was no elaborate ribbon-cutting ceremony, only two black internal encrypted pagers and a red backpack full of endotracheal tubes, cardiac stimulants, and resuscitation equipment.

"Starting today, the emergency department will no longer just wait for patients downstairs." Qin Hai slammed one of the call machines onto Lin Ye's table. "The RRT team's authority covers the entire hospital. Whether it's the outpatient hall, general wards, or medical technology examination area, as long as the blue life alarm is sounded, the RRT must arrive at the scene with a first aid kit within three minutes and take over the command of the rescue on the spot."

Lin Ye picked up the heavy pager and exchanged a glance with Fang Rui, who was carrying a red first-aid kit on his back. They both saw the seriousness in each other's eyes.

Thursday, day shift.

The emergency room was as noisy as ever. Lin Ye had just finished treating a patient with acute renal colic and was about to take a sip of water.

"Beep—beep—beep—!"

A piercing alarm suddenly blared at the nurses' station. This wasn't the usual 120 ambulance call bell; it was the highest-level alarm from the dedicated RRT call machine!

Fang Rui sprang up as if he had been electrocuted, grabbed the heavy red first-aid kit weighing over ten kilograms, and slung it over his shoulder.

Lin Ye grabbed the pager and pressed the answer button: "Emergency RRT received, please state your location and situation!"

The voice on the other end of the phone was clearly panicked; you could even hear the patient's screams and the erratic noises of medical equipment in the background: "This is the 8th floor, Psychiatric Ward 3! Male, bed 15, 22 years old, suddenly developed a high fever of 40.2 degrees Celsius, heart rate 140, and is unconscious! Suspected septic shock caused by severe encephalitis or sepsis. Requesting immediate emergency assistance for transport upstairs!"

Psychiatric ward?

Lin Ye's pupils contracted slightly.

The Department of Psychiatry is the most special department in the entire First Municipal Hospital. It is under complete closed management. The doctors there are absolutely experts in dealing with schizophrenia, manic episodes, and psychological crises. However, because they rarely deal with acute physical exhaustion, they often lose their grip on such internal medicine emergencies.

"Fang Rui, grab the defibrillator, let's go!"

Without uttering a single unnecessary word, Lin Ye hung up the phone and, with Fang Rui, rushed out of the nurses' station like a gust of wind.

"bite--"

After Lin Ye swiped his RRT access card, the medical elevator dedicated to the emergency department forcibly cleared all stop requests along the way and rushed straight to the eighth floor with a heart-pounding push.

The moment the elevator doors opened on the eighth floor, a completely different sense of oppression washed over me.

At the end of the corridor is a heavy iron gate, leading to a closed-off ward for severely mentally ill patients.

The nurse on duty was already waiting behind the door. Upon seeing Lin Ye and the others, she immediately swiped her card to open the door: "Quick! Over here!"

The two followed the nurse down the corridor.

Compared to the bright and airy emergency room, the windows here are all fitted with protective netting, and there is an indescribable stuffy smell in the air.

When they rushed into ward number 15, the scene was already in complete chaos.

A young man in his early twenties was secured to the hospital bed with multiple restraint straps.

His eyes rolled back, his breathing became extremely rapid, and he looked as if he had been pulled out of the water. His hospital gown and sheets were completely soaked with sweat.

Two psychiatrists were sweating profusely with anxiety. One of them, a bespectacled attending physician, saw Lin Ye and rushed over as if grasping at a straw: "Dr. Lin! The patient's name is Chen Kai. He has bipolar disorder that has progressed to a manic episode. This morning he suddenly developed a high fever. We gave him antipyretics and tried physical cooling methods, but they couldn't bring it down at all. Now his heart rate is consistently above 140, his blood pressure is fluctuating wildly, and he's unresponsive!"

"I'll establish an intravenous line for blood draw!" Fang Rui put down the first aid kit, quickly took out a tourniquet and an indwelling needle, and rushed to the left side of the bed, trying to straighten the patient's arm.

However, Fang Rui pulled hard, but couldn't budge it.

"Huh?" Fang Rui was taken aback, thinking that the patient was subconsciously resisting, so he increased the force to pry Chen Kai's arm open.

"Teacher Lin!" Fang Rui's expression suddenly changed, his voice filled with shock, "His arm is unbendable! It's completely stiff!"

Lin Ye frowned sharply and strode to the right side of the hospital bed.

He reached out and grasped Chen Kai's right arm, then tried to flex and extend the patient's elbow joint with a little force.

An extremely strange sensation reached Lin Ye's palm. It wasn't the feeling of a patient's tense muscles when they were nervous; rather, it was a stiffness with uniform resistance that couldn't be moved no matter how hard he tried—like trying to bend a solid lead pipe!

"Lead-pipe ankylosing spondylitis!" The medical term flashed through Lin Ye's mind instantly.

He quickly reached out and touched Chen Kai's chest, abdomen, and lower limbs. Without exception, all of the patient's skeletal muscles were in a state of extreme tetanic contraction, as hard as a rock!

"What medicine did you give him?!" Lin Ye suddenly turned his head, staring sharply at the attending psychiatrist.

"He had a manic episode last night, smashing the ward window. Several male nurses couldn't hold him down. To prevent him from harming himself or others, we administered haloperidol intramuscularly according to psychiatric sedation protocols, and later added a little olanzapine..." The attending physician was startled by Lin Ye's gaze and quickly reported the medication history, "These are all standard dosages; there's absolutely no overdose!"

"Even regular doses can be fatal!"

Lin Ye's heart sank.

[Sedation with medication] + [Extremely high fever of 40.2 degrees Celsius] + [Generalized lead-pipe rigidity] + [Profuse sweating, autonomic dysfunction].

These four conditions, when perfectly combined, immediately triggered the highest-level death alarm in Lin Ye's mind.

This is neither severe encephalitis nor sepsis.

Psychiatrists have been completely misled by the ingrained mindset of "infection"!

"This is not an infection!"

Lin Ye ripped open Chen Kai's hospital gown by the collar.

"This is NMS (Negative Mental Syndrome) caused by antipsychotic medication! The patient's muscles are spasming and contracting wildly due to the drug reaction, and heat production is out of control!"

The attending psychiatrist gasped.

Malignant syndrome, an extremely rare complication that only exists in the corner of textbooks, has a staggering mortality rate of 20% to 30%.

"Fang Rui, forget about his arm. Because of the peripheral vasoconstriction caused by the continuous muscle spasms, you can't insert an IV catheter at all. Get a large-sized puncture kit ready and create a double femoral vein access! Immediately draw blood to check creatine kinase (CK), myoglobin, and kidney function!" Lin Ye took over the command, issuing instructions at lightning speed. "His muscles are like they're being put into a meat grinder right now. Severe rhabdomyolysis will occur soon, and the large amount of myoglobin will completely block his kidneys!"

Lin Ye turned to the psychiatrist: "Immediately stop all antipsychotic medications! Notify the EICU to prepare a resuscitation bed, and bring all the ice packs your department can borrow, covering his major artery pulse area! Prepare to push him downstairs, bed and all!"

In this isolated eighth-floor ward, which was known as a closed island, the first attempt by the emergency RRT (Recovery and Respiratory Treatment) directly ran into a major hidden danger that was tightly concealed by the barriers of specialization.