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

In the corridor of the eighth-floor psychiatric ward, the wheels of the hospital bed rolled over the terrazzo floor tiles. Lin Ye was at the head of the bed, controlling the direction, while Fang Rui was on the side, tightly gripping the IV bag. Dr. Wang from the psychiatric ward and two male nurses were pushing the cart desperately from behind.

The group of people, like a runaway chariot, raced toward the ICU elevator at the end of the corridor.

"Temperature 40.5 degrees! And it's still rising!" Fang Rui glanced at the transport monitor hanging by the bedside, his voice trembling.

Just as the hospital bed was about to burst through the last iron gate of the psychiatric ward, the monitor suddenly emitted a high-frequency, piercing alarm that sent chills down one's spine!

[Blood oxygen saturation (SpO2): 85%...78%...65%!]

The blood oxygen waveform on the screen instantly turned into an extremely faint undulating line. Chen Kai's face, which was originally flushed due to high fever, turned bluish-purple at a visible speed, and the veins on his neck bulged due to extreme lack of oxygen.

"He's not breathing!"

Dr. Wang, a psychiatrist, was so frightened that he screamed.

"stop!"

Lin Ye shouted, and the hospital bed came to a screeching halt on the anti-slip mat in the corridor, the tires screeching as they rubbed together.

"Fang Rui, a simple breathing bag!"

Lin Ye ripped off the ordinary oxygen mask from Chen Kai's face, lifted the patient's chin, and tried to open the airway.

Without a second's hesitation, Fang Rui pulled out a simple respirator from the red RRT first aid kit, connected it to a portable oxygen cylinder, and tightly fastened the transparent mask over Chen Kai's mouth and nose, squeezing the bag with both hands.

"Sizzle—"

The balloon was flattened, but instead of the high-pressure oxygen being blown into the patient's lungs as expected, it leaked out along the edge of the mask, making a sharp hissing sound.

Chen Kai's chest remained completely still.

"It won't go in!" Fang Rui was sweating profusely, pushing the balloon down with all his might, the veins on the back of his hands bulging. "Teacher Lin, the air won't go in! The resistance is ridiculously strong, it feels like blowing air into a concrete wall!"

Lin Ye placed his palm on Chen Kai's chest, his face instantly turning extremely gloomy.

The worst thing still happened.

"It's thoracic ankylosis!" Lin Ye spoke rapidly. "The systemic muscle spasms caused by malignant syndrome have spread to his respiratory muscles. His chest wall is now like a welded-together iron barrel; squeezing the saccule by hand won't inflate his lungs at all!"

"What should we do? He'll suffocate!" Dr. Wang, a psychiatrist, was in a state of extreme panic as he looked at the patient who had turned completely cyanotic.

They usually deal with psychological crises, but they've never seen a physical predicament where someone could die at any moment.

"Fang Rui, prepare for intubation on the spot! Dr. Wang, lay his bed flat and remove the pillows!"

In a corridor without any rescue equipment or even a shadowless lamp, emergency intubation was performed on the spot! This is the cruelty of RRT—wherever death knocks, that's where the battlefield is.

Although Fang Rui's hands were shaking, the high-pressure training in the emergency department allowed his movements to retain muscle memory.

He pulled open the second layer of the first aid kit and took out the laryngoscope and the No. 7.5 endotracheal tube.

"The patient's masseter muscles are locked in a rigid state; his mouth can't be opened at all!" Fang Rui tried to pinch Chen Kai's cheeks, but found the patient's jaw clenched tightly, as if cast in molten iron. "Teacher Lin, we need to administer induction drugs and muscle relaxants before we can insert it!"

"Prepare the medicine!"

Lin Ye put on gloves and took the laryngoscope.

Fang Rui immediately turned around, pulled out two of the most commonly used drugs for rapid induction intubation (RSI) in the emergency room from the medicine box, skillfully broke the ampoules, and drew them in with a syringe.

"Propofol 50 mg for sedation, prepare for bolus injection," Fang Rui announced loudly.

"Push!" Lin Ye stared intently at the patient's vital signs.

"Succinylcholine (Succinylcholine), 100 mg, the fastest-acting depolarizing muscle relaxant, to be administered via bolus."

Fang Rui raised the second syringe and aimed it at Chen Kai's intravenous access tube.

In the common sense of the emergency department, when faced with a patient with masseter muscle spasm who urgently needs airway resuscitation, succinylcholine, a drug that can paralyze the whole body's muscles in a few tens of seconds, is definitely the first choice for saving lives.

However, just as Fang Rui's thumb was about to press the syringe piston...

"Snapped!"

A large hand wearing a rubber glove gripped Fang Rui's wrist tightly like an iron clamp!

The immense force caused Fang Rui's fingers to stiffen abruptly, and the medicine in the syringe was abruptly stuck at the intravenous access point.

Fang Rui looked up in astonishment.

"He died after this injection was administered."

"Huh?" Fang Rui was completely dumbfounded. "But without Si Kelin, he can't open his mouth at all!"

"Look closely at his current condition!" Lin Ye pointed at Chen Kai's muscles, which were as stiff as stone, and shouted sharply, "He's suffering from severe muscle rigidity throughout his body due to malignant syndrome! His skeletal muscle is undergoing massive dissolution and necrosis, and extremely high concentrations of potassium ions are being released into his bloodstream!"

Fang Rui's pupils suddenly contracted, and his mind went blank as he instantly realized what was happening.

Succinylcholine is a "depolarizing" muscle relaxant! Its mechanism of action is to induce a violent contraction (depolarization) in the muscle before it becomes paralyzed.

If this amber choline is injected into a patient who has already developed rhabdomyolysis and whose blood potassium levels may be fatally high, it will cause potassium ions in the muscle cells to rush into the bloodstream in a cascade-like manner!

That would be a fatal, irreversible hyperkalemic ventricular fibrillation!

As soon as this dose of medicine is administered, Chen Kai's heart will absolutely stop beating forever within ten seconds, right here on the corridor floor tiles!

Fang Rui felt a chill run from the soles of his feet straight to the top of his head. He jerked his hand holding the syringe back as if he were holding a red-hot iron, and his back was instantly soaked with cold sweat.

He almost killed the patient with his own hands.

"Switch to a non-depolarizing muscle relaxant! Rocuronium or Vecuronium! Quickly!" Lin Ye released his grip and issued the substitution order without hesitation.

With trembling hands, Fang Rui pulled out a rocuronium bromide vial from the deepest part of the medicine bag at the fastest speed he had ever done, drew it up, and injected it!

Although rocuronium bromide takes a minute longer to take effect than succinylcholine, it is the only safe option they can choose.

Several dozen seconds later, the drug finally took effect. Chen Kai's tightly locked masseter muscles finally showed a slight twitch.

"Dr. Wang, hold the headboard steady, don't let it slip! Fang Rui, hold down his cricoid cartilage to expose the glottis!"

The overhead lights in the corridor were dim and flickering, providing extremely poor lighting.

Lin Ye placed his left foot directly on the bed frame, half of his body dangling forward, and with his left hand holding the laryngoscope, forcibly inserted it into Chen Kai's mouth.

Using the faint cold light from the tip of the laryngoscope, Lin Ye's gaze pierced through the large amount of viscous secretions, and in the bloody and blurred vision, he accurately captured that fleeting slit in the glottis.

"catheter!"

Fang Rui shoved the endotracheal tube into Lin Ye's right hand.

With a flick of his right hand, Lin Ye guided the catheter smoothly into the glottis and into the trachea.

Remove the core tube, inflate the cuff, and connect the simple respirator.

"pinch!"

Fang Rui squeezed the balloon with both hands. This time, without the chest wall muscles locking it in, Chen Kai's stiff chest finally rose and fell slowly as oxygen was forced in.

"Listen to both lungs to confirm the location."

Fang Rui put on his stethoscope and listened to Chen Kai's chest walls twice: "Bronchoscopy is symmetrical, the endotracheal tube is in the trachea! Blood oxygen is starting to rise! 75%...82%...90%!"

In the corridor, the two psychiatric nurses were so weak in the knees that they leaned against the wall, and Dr. Wang was panting heavily.

"Well done." Lin Ye wiped the sweat from his brow, turned, and kicked open the fire door of the elevator shaft. "He's saved a life. Now, take him to the EICU for dialysis and detoxification!"

Several people exerted their strength at the same time, pushing the hospital bed full of tubes like a heavy tank, and roared into the RRT's private elevator.

The elevator doors slowly closed, and the bright red numbers began to drop rapidly.

Lin Ye watched as the blood oxygen level on the monitor gradually stabilized at 95%, and let out a long breath. His vision was clear; the system screen, representing the dire situation, remained unlit.

Before this common-sense trap completely swallowed the patient, this young doctor, known as the "safety net" of the emergency department, had already used his ironclad medical principles to keep death firmly in the corridor on the eighth floor.