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

"The filter membrane has completely solidified!"

Fang Rui stared intently at the blood purification machine. The micropores in the transparent plasma separator, which were originally filtering out replacement fluid, were now completely blocked by dark blood clots and fragments of red blood cell membranes.

The thin polymer membrane could not withstand the torrential hemolysis within the microvessels.

"The machine has been forcibly stopped!" The attending physician shoved his chair away abruptly. "The pressure at the arterial end has exploded! Blood can't get back!"

At this moment, the bus driver's extracorporeal circulation system contained a full 200 milliliters of blood.

For a patient with severe anemia whose hemoglobin level has dropped below 50 g/L, if the blood completely clots in the tubing, it's like having a life-saving tube of oil ripped out of their heart.

"Give me a pair of large curved pliers!"

Lin Ye strode to the bedside and grabbed the freshly drawn high-concentration heparin saline solution from the treatment tray.

Nurse Zhao slapped a sterile, large curved hemostat into his palm.

Click.

Lin Ye precisely clamped the hemostat into the arterial line at the front of the plasma separator, blocking the backflow of blood into the waste filter.

He unscrewed the heparin cap on the intravenous infusion vessel and inserted a 20ml high-concentration heparin saline syringe into the port.

Press your thumb down on the injection rod and apply force.

It can't be pushed.

The blood in the tubes had become visibly thick and layered, and the cascade of coagulation was spreading in seconds.

"It won't go in!" Fang Rui looked at the blackened bloodstains on the tube wall. "It's all congealed!"

"We must push them back; we can't afford to lose a single drop of blood!"

Lin Ye gritted his teeth, his wrist veins bulging, and pressed all his weight onto his right thumb, forcefully pushing down on the syringe plunger.

呲——

The extremely viscous resistance was finally forcibly torn open by the high-pressure brine, creating a channel.

The clear saline solution mixed with heparin pushed the dark red blood in the tubing, slowly and steadily flowing back into the patient's subclavian vein along the venous return pathway.

The first 20ml vial was completely dispensed.

Lin Ye quickly removed the empty needle, replaced it with a second one, and continued high-pressure injection.

A full forty milliliters of heparinized saline solution forcefully flushed away the remaining blood in the venous chamber and tubing, forcing it all back into the struggling body.

"The blood has returned."

Lin Ye released the plunger, his fingers trembling slightly, and cold sweat beaded on his nose.

"The blood has returned, but the machine is completely broken." The attending physician looked at the wrecked plasma separator, his voice filled with despair. "The separation membrane is broken, and the blood bank has no plasma. The toxins are still dissolving red blood cells in his veins. Are we just going to watch him drown in blood?"

On the hospital bed, the pink frothy sputum that had just decreased in the transparent corrugated tube showed signs of rising again.

Deep in the distance, the countdown timer ticked silently:

【01:06:12】

【01:06:11】

Lin Ye took a half step back and stared intently at the sturdy cylindrical component at the rear of the pipeline—the neutral macroporous resin adsorption tank.

The DPMAS system we just discussed first uses a separation membrane to separate the "plasma," and then allows the plasma to flow through a resin tank to adsorb toxins, so as to prevent coarse resin particles from indiscriminately damaging blood cells.

But now, the separation membrane is ruined.

"Sister Zhao, remove the plasma separator." Lin Ye pointed to the machine with its red light flashing wildly. "Connect the arterial and venous tubing directly to that resin adsorption tank; we'll do direct whole blood perfusion!"

The attending physician's eyes widened instantly: "Are you crazy? Whole blood going directly into the resin tank? He's already undergoing hemolysis; his red blood cells are so fragmented they've even clumped together the filter membrane! If you let whole blood flush the resin now, his platelet count will plummet, causing massive hemorrhage!"

"If we don't adsorb it now, the fat-soluble toxins in the high-pressure refrigerant will continue to clog all the capillaries," Lin Ye said rapidly. "Whole blood perfusion does consume some platelets. But it's currently the only physical pathway to remove the toxin!"

Between two evils, choose the lesser. Without removing the poison, there is a 100% chance of dying from hemolytic pulmonary edema and suffocation; with whole blood perfusion, there is a 50% chance of surviving the consumptive period.

"Who will be responsible if something goes wrong?"

The attending physician's back was completely soaked.

"I take full responsibility."

Lin Ye turned his head. Outside the glass door, Liu Zhenhua still stood in the shadows of the corridor lights, his gaze cold and hard. He neither pushed the door open to stop him nor gave any gesture. Non-interference was the greatest authorization.

"Prepare to take over!" Nurse Zhao ripped off her sterile gloves, put on new ones, and clamped the clips at each joint.

Fang Rui, together with Nurse Zhao, forcibly dismantled the discarded plasma separator directly from the pipeline.

The waste liquid bag was kicked away.

The connecting tube is connected. Pre-flush, vent, and fully heparinize.

"Pipeline shorting complete!" Nurse Zhao glanced at the pressure gauge.

"Mount the pump."

The roller pump roared back to life. Dark red blood, flowing directly into the adsorption tank filled with microporous resin through the thick, transparent tube, was released without any buffer. The resin micropores began to frantically devour the lipid-soluble toxins, while red blood cells struggled to navigate between the particles.

Ten minutes. Twenty minutes. Thirty-five minutes.

The pressure curve from extracorporeal circulation miraculously stabilized. The full-volume heparinized saline solution provided protection, and no serious secondary clotting occurred in the resin tank.

"Teacher Lin! Your blood oxygen level has gone up!"

Fang Rui pointed to the monitor.

Originally struggling with a pulse oxygen saturation of 88%, it slowly but steadily climbed to 94%.

Inside the bellows, the horrible pink frothy sputum stopped rising.

In the drainage bag at the foot of the bed, the fifty milliliters of urine that had just been expelled had gradually faded from dark red to a tea-colored hue.

Hemolysis was contained.

Lin Ye felt as if his legs were filled with lead.

Deep within the field of vision, the countdown timer flashed twice:

【00:14:02】

【00:14:01】

Immediately, the color of the numbers faded, disappearing completely without a trace.

outside the hallway.

Liu Zhenhua glanced at the data in the ICU, silently took out the signed special approval form from his pocket, folded it flat, and strode towards the administration building.

There were countless tough battles to come, but he got the result he wanted.

It's 7:30 in the morning.

Next to the sink in the emergency department, the tap was turned on full blast.

Lin Ye washed his hands and looked at himself in the mirror.

His eyes were bloodshot, and he had a bluish-black stubble on his chin.

Exhausted, Fang Rui slumped against the defibrillator and dozed off.

The doctors and nurses on the day shift are gradually clocking out and handing over their duties.

Woo--dudududu--

The piercing siren of an ambulance came without warning from outside the emergency room, the red and blue flashing lights tearing through the morning.

"Quick! Car accident, external injuries! Push the cart to catch him!"

Nurse Zhao's sharp voice rang out again.

Lin Ye turned off the tap, wiped the water off his white coat, and turned to walk towards the red zone.