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

The shouting on the red internal telephone receiver abruptly stopped, leaving only a rapid busy tone.

Guo Shusen held the receiver, his face ashen, his hands trembling so much he almost dropped the phone.

"More than twenty people... Erdaowan is a deep ravine with a 30-meter drop in elevation and loose gravel!" Guo Shusen's voice trembled. "The emergency room usually only has three doctors on duty, and with that grappling injury, all the resuscitation beds are full... How can we take them all in? Should we call the Municipal Health Bureau now and request a full transfer?"

"Transfer them? The bus rolled down a 30-meter-deep ditch, its body severely deformed, riddled with crush injuries, multiple fractures, and massive bleeding!" Lin Ye removed his sterile gloves, soaked in saline solution, his tone calm and decisive. "Transferring them from Cangshan to the city involves traversing eighteen winding mountain roads; the seriously injured will all suffocate and bleed to death on the way! We must intercept them on the spot and divert them immediately!"

Yan Mingcheng rushed over, his expression extremely serious: "Captain Lin, I'll coordinate the entire hospital. You understand trauma first aid, so we'll follow your lead on the spot!"

"Dean Yan, immediately activate the Level I emergency response for this public health emergency!"

Without the slightest hesitation, Lin Ye issued three instructions in rapid succession:

"First, broadcast this message throughout the hospital: all off-duty medical staff from the surgery, orthopedics, anesthesiology, and ICU departments located in the county seat, assemble in the emergency room lobby within fifteen minutes!"

"Secondly, the entire security team was mobilized to clear all private cars and trolleys from the ramp leading to the emergency room and set up a one-way emergency lane; all patients with mild symptoms in the infusion room were transferred to the second-floor ward, and the first-floor lobby was completely emptied!"

"Third, Dr. Zhao, you and the county surgeons will take control of operating rooms number one and two, inventory the exploratory laparotomy kits and thoracotomy instruments, and prepare to transfer all patients with life-threatening massive bleeding!"

"Understood, leave the operating table to me." Zhao Feng's eyes were serious as he quickly turned around to arrange the surgical instruments.

Liang Shumin immediately followed up: "I led the gynecologists and internists to the emergency room's second resuscitation area, where we were responsible for airway management, shock resuscitation, and screening of pregnant women and children."

"Director Guo, you're familiar with the hospital's inventory. Immediately take some people and move all the hospital's folding stretchers, oxygen bags, and neck braces to the emergency room entrance!"

Guo Shusen was taken aback by Lin Ye's clear and forceful command, and subconsciously straightened his back: "Okay, I'll take care of it right away!"

A piercing alarm suddenly blared over the Cangshan County People's Hospital.

The first batch of transport vehicles rushed up the emergency room ramp.

Leading the way was a traffic police SUV with flashing lights, followed closely by a farm pickup truck and a van covered in yellow mud.

As soon as the car door was opened, heart-wrenching cries and groans flooded the emergency room's front yard.

The truck bed was filled with passengers covered in mud and blood.

A young man with a cut on his forehead from broken glass and blood streaming down his face stumbled out of the car, grabbing a nurse's sleeve and shouting:

"Doctor! Save me first! I'm bleeding so much, I'm dying!"

The young nurse was pulled so hard she stumbled, and frantically pulled out a gauze pad to press on it.

A large number of passengers with minor injuries rushed forward, instantly blocking the entrance to the emergency room.

"open!"

Lin Ye strode forward, pushing aside the crowded people, his left arm clad in a bright red emergency command armband.

He stood on the emergency room steps, his voice cutting through the cacophony of cries:

"All wounded soldiers who can stand and walk on their own, immediately follow the instructions of the security department and go to the infusion hall on the left—there are doctors there to clean and bandage their wounds!"

Lin Ye spoke rapidly: "Don't block the main entrance! Make way for critically injured people who can't be moved! Anyone who blocks the way is delaying rescue efforts!"

Four security officers immediately stepped forward to guide the flow of people, shouting and waving to direct them.

The lightly injured passengers, who were crying and shouting in front of the door, paused for a moment, then followed the security team to the left side of the hall.

The congestion at the main entrance was immediately alleviated by 70%.

"START Triage!" Lin Ye gave the order to the emergency room staff around him as he put on his examination gloves. "First, screen for minor injuries that the patient can walk, then check breathing, circulation, and consciousness! Red for critical, yellow for emergency, green for minor injury, black for death! Check one patient every thirty seconds, don't waste time on minor injuries!"

The medical staff quickly split into two groups and rushed to the pickup truck bed and the SUV.

Lin Ye jumped into the bed of a pickup truck covered in mud.

Five passengers, unable to walk, were lying haphazardly in the truck bed.

Lin Ye squatted down next to the first wounded soldier.

He was a young man in his early twenties with a deformed right calf, the white bone fragments piercing through his trouser leg and protruding. He was in so much pain that he was covered in cold sweat and screaming in agony.

Lin Ye quickly touched the dorsalis pedis artery in the right foot with his index finger, and the pulse was clear and strong; when he pressed the nail bed, the capillary filling time was less than two seconds; the breathing was steady and the patient was conscious.

"Closed fracture with localized open fracture, good circulation, no hemorrhagic shock." Lin Ye pulled out a yellow triage card and attached it to the injured person's wrist. "Yellow tag! Simple splint fixation, take the stretcher to treatment room number two to await bone setting!"

He stepped over the truck bed and walked toward a middle-aged man in the corner.

The man made no sound at all, leaning against the metal plate of the carriage, his face ashen, his lips and nails severely cyanotic.

The man's breathing was extremely shallow and labored, with a dry, bellowing sound coming from his throat, and his breathing rate was at least thirty-five breaths per minute!

Just as a county emergency room doctor reached for his stethoscope, Lin Ye grabbed his wrist:

"Don't listen, check the vital signs!"

Lin Ye unbuttoned the man's coat with one hand.

The man's left chest wall was noticeably bulging and full, his breathing movements had completely disappeared, his trachea in his neck was pushed to the right, and his jugular veins on both sides were bulging like two earthworms!

Lin Ye lightly tapped the man's left chest with his index and middle fingers, and heard a deep and hollow high-pitched drum sound in his ear.

"Massive tension pneumothorax on the left side with severe mediastinal shift! High-pressure gas in the pleural cavity is compressing the affected lung, causing mediastinal shift to the opposite side and obstructing venous return!"

At the edge of my field of vision, a faint, ghostly blue countdown number suddenly appeared:

【00:04:18】

"Push the cart to the emergency room for closed drainage!" The doctor next to him hurriedly called for the cart.

"It's too late! Tension pneumothorax will cause cardiac arrest within four minutes. Getting him into the emergency room to prepare a water-seal bottle will take at least five minutes!"

Without the slightest hesitation, Lin Ye quickly pulled out a 14G diameter intravenous catheter from the side pocket of his emergency chest bag and removed the cap.

"Iodine solution!"

The county doctor hurriedly handed over iodine-soaked gauze.

Lin Ye ran his hand across the second intercostal space along the left clavicle midline of the wounded soldier, his fingertips quickly finding the upper edge of the second rib.

Avoid the subcostal nerve and blood vessel bundle, aim at the upper edge of the rib and decisively insert the needle!

puff!

The tough chest wall muscle layer was breached, and the needle penetrated the parietal pleura and entered the high-pressure pleural cavity.

The moment the needle core was pulled out, a piercingly loud burst of high-pressure air whistled out from the end of the plastic sleeve, sounding like a pressure cooker releasing steam!

Lin Ye quickly slipped a sterile latex glove with its fingertips cut off onto the end of the cannula, creating a simple one-way valve—when exhaling, air rushes out of the fingertip and is expelled; when inhaling, the soft fingertip automatically collapses and closes to prevent air from flowing back in.

The middle-aged man, who had been cyanotic and suffocating, suddenly convulsed and inhaled a long breath of air.

The man's bluish-purple complexion quickly turned rosy, and his engorged jugular veins gradually subsided.

The countdown numbers at the edge of my vision flickered briefly before going out.

"Tension pneumothorax successfully treated with puncture and decompression; mediastinum returned to normal!" Lin Ye pinned a dark red triage card to the man's chest. "Red mark! Immediately transfer him to the emergency room, connect him to a closed chest drainage bottle, and administer high-flow oxygen!"

Two nurses quickly moved the middle-aged man onto the ambulance and pushed him into the emergency room.

The sirens outside continued to wail, and two more SUVs pulled up in the emergency lane.

Lin Ye wiped the cold sweat from his face and had just jumped out of the pickup truck bed when the last traffic police SUV with flashing lights screeched to a halt in front of the door.

Two traffic police officers, sweating profusely, opened the back door of the car, their voices urgent:

"Doctor! Come quick, look at this! When the bus rolled over, the metal armrest of the seat broke off and went straight through this girl's lower right abdomen!"

Lin Ye rushed forward quickly.

A young woman in her twenties was lying in the back seat of the car, unconscious.

A hollow iron pipe, about the thickness of two fingers and with a serrated break, was deeply embedded between her right groin and lower abdominal wall. The area around the wound was stained with dark blood, and her abdominal wall was taut and swollen.

Liang Shumin rushed over, reached out and felt the carotid artery, her face changing drastically: "Systolic blood pressure is only 40 mmHg, pulse is as weak as a thread, penetrating injury to the pelvic and abdominal cavities combined with active massive bleeding!"

The operating room door opened, and Zhao Feng strode to the steps, his gaze falling on the iron pipe piercing his lower abdomen. His voice was calm and decisive:

"The iliac vessels or major abdominal organs have been damaged. Send them to operating room number one and start operating immediately!"