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

On the third night, Lin Ye printed out ten copies of the high-risk list.

The paper, still warm from the printer, was posted one by one by Nurse Zhao at the nurses' station, triage desk, emergency room entrance, and doctor's office.

Sun Zhiqiang looked at the first rule and read it aloud:

"Patients with atypical chest and abdominal pain but accompanied by abnormal vital signs should not be simply triaged as ordinary stomach pain, anxiety, or discomfort after drinking alcohol."

He looked up at Lin Ye: "You wrote down your first night shift as your first entry?"

Lin Ye said, "Chen Jianguo's experience was a huge lesson."

"Okay." Sun Zhiqiang flattened the paper. "It's just that there are too many words; it'll strain my eyes to read at night."

Nurse Zhao immediately circled a few words in red pen: "Abnormal vital signs. These six are enough."

At 11 p.m., a familiar patient came to the triage desk.

Lin Ye didn't know him.

We see people like this every day in the emergency room.

The man, in his fifties, wearing an old jacket, clutched a bag of dialysis forms. His face was ashen, but he kept saying, "I'm just feeling a bit weak, and my stomach feels nauseous. I'll do dialysis tomorrow; I don't want to go through the ordeal today."

His daughter, who had accompanied him, stamped her foot anxiously: "Dad, you can barely stand, and you're saying tomorrow!"

The triage nurse glanced at the form: "Regular dialysis for uremia?"

The daughter nodded: "Three times a week. I didn't go the day before yesterday because I said the roads were slippery from the rain. Today I said I felt tightness in my chest and nausea."

The man said impatiently, "I don't have any chest tightness. It's just that my stomach is upset. You young people always scare me like this."

Nurse Zhao happened to be passing by and her eyes fell on the dialysis form in his hand.

"Do the electrocardiogram first."

The man frowned: "I don't have a heart condition."

Nurse Zhao helped him into the wheelchair: "Whether you have heart disease or not is not your business."

Upon hearing "dialysis, weakness, nausea," Lin Ye turned around.

A system notification popped up.

[Emergency room alert activated.]

High-risk factors: severe hyperkalemia, malignant arrhythmias.

[Key abnormalities: missed dialysis, fatigue, nausea, chest tightness; denial is unreliable.]

[Risk window: 16 minutes 27 seconds.]

He looked at the monitor.

Heart rate 52, blood pressure 158.82, oxygen saturation 98.

It's not shock.

But it sends chills down your spine even more than shock.

"What's your name?"

The daughter handed over the dialysis form: "Zhao Guobin."

When was the last time you had dialysis?

Zhao Guobin said impatiently, "Three days ago."

The daughter immediately exposed her: "Four days ago. You didn't go the day before yesterday."

"Have you eaten anything? Bananas, oranges, low-sodium salt?"

The daughter's expression changed: "He's been eating a lot of oranges these past two days. He even said low-sodium salt is healthy."

Zhao Guobin glared at her: "Why do you say everything?"

Lin Ye wasn't swayed by him: "Immediately perform an electrocardiogram, draw electrolytes, kidney function tests, and blood gas analysis. Notify the nephrology department and dialysis unit; high potassium is suspected."

Sun Zhiqiang came out of the office: "Do you have an electrocardiogram?"

The nurse attached the electrodes.

The paper was ejected from the machine, its sharp T-waves resembling a row of upright needles.

Sun Zhiqiang's expression changed: "Tall T waves, slow heart rate. Potassium levels can't wait for testing. Director Qin!"

Qin Hai came over from the emergency room and glanced at the electrocardiogram: "Move into the red zone. Calcium to protect the myocardium, prepare for potassium reduction, nephrology team to arrive immediately, turn on the dialysis machine."

Zhao Guobin tried to stand up again: "Can I go for dialysis tomorrow? I still have chicken soup simmering at home."

Nurse Zhao grabbed the armrest of the wheelchair: "If you keep thinking about chicken soup, no one will drink it."

The daughter cried in terror, "Doctor, will he die?"

Lin Ye handed her the electrocardiogram.

"High blood potassium can cause sudden cardiac arrest. The electrocardiogram has already shown changes, so we can't wait until tomorrow."

The daughter nodded repeatedly: "Treat him, treat him right away."

Seeing his daughter cry, Zhao Guobin finally softened his tone.

"It's just one less time..."

Dr. He Jianye, the head of the nephrology department, arrived ten minutes later.

His hair was a complete mess, and the first thing he said when he walked in wasn't to berate the emergency room, but to berate the patients.

"Zhao Guobin, you missed another dialysis session?"

Zhao Guobin was stunned: "Director He?"

He Jianye sneered: "You still recognize me, which means your brain isn't completely ruined by potassium poisoning. What did I tell you last month? You can't just eat low-sodium salt, you can't eat fruit like this, and you can't have dialysis leaks!"

Zhao Guobin shrank his neck.

Lin Ye then realized that the patient was an old acquaintance from the nephrology department.

He Jianye looked at the electrocardiogram and then at the monitoring equipment: "Has treatment been initiated?"

Sun Zhiqiang reported: "Calcium has been administered, insulin and glucose are ready, nebulization and acid correction will be performed as needed, and the dialysis machine is now operational."

He Jianye nodded: "Okay. Don't wait until the tests are back to get started; this electrocardiogram has already come knocking."

No sooner had the words left his mouth than the monitor suddenly emitted a sharp alarm.

Zhao Guobin rolled his eyes and his body went limp.

The electrocardiogram waveform was completely messed up.

"Ventricular tachycardia!"

The emergency room sprang into action instantly.

Qin Hai's voice deepened: "Prepare for defibrillation!"

The daughter screamed and was pulled out of the emergency line by Nurse Zhao.

"Don't touch the bed!"

Lin Ye pressed down on Zhao Guobin's shoulder, his mind filled only with the monitoring waveforms and Qin Hai's instructions.

The system countdown was jumping extremely fast.

[A malignant arrhythmia has occurred.]

[Risk window: 02 minutes 11 seconds.]

It still doesn't offer a solution.

Qin Hai was already standing at the head of the bed.

The drawer of the ambulance was pulled open, and electrode plates were handed to him.

Nurse Zhao shielded her daughter with one hand and reached for the defibrillator cable with the other.

"Charge!"

"Get out of bed!"

After being electrocuted, Zhao Guobin's body jolted violently.

The waveform malfunctioned for a few seconds before slowly returning to a recognizable rhythm.

"Restore perfusion rhythm." Sun Zhiqiang stared at the monitor. "Heart rate 64, blood pressure 137-138."

The daughter covered her mouth outside, crying so hard she couldn't make a sound.

He Jianye said with a stern face: "Send him to the dialysis room immediately, and keep him under constant monitoring during the journey."

Qin Hai looked at Lin Ye: "Transfer assessment."

Lin Ye quickly checked: "Defibrillator is on board, emergency medications are provided, monitoring equipment is available, oxygen is supplied, a nephrologist is on board, and the dialysis unit is already operational."

Nurse Zhao slapped the transfer verification form over: "Sign."

Zhao Guobin regained some consciousness, but his voice was so weak it was almost inaudible.

"Did I almost make it?"

He Jianye leaned down: "It wasn't 'almost,' you already knocked twice on the door."

Zhao Guobin looked at his daughter, and his eyes finally showed panic.

"I won't leak anymore... from now on."

Nurse Zhao said coldly from the side, "You should say that to the dialysis room; they're more familiar with them."

The system prompts you to refresh.

[Patients in the red zone: Entering effective treatment procedures.]

[Current night shift: Night 3.]

[In-hospital deaths: 0.]

[Emergency Room Weekly Progress (Zero Fatalities): 3/7, Pending Confirmation]

Lin Ye looked at the high-risk list on the wall of the nurses' station.

The first line was posted less than three hours ago, and then the red pen moved it to the bottom of the same line again.

Sun Zhiqiang saw it too.

He walked over, took a red pen, and added a line below the first one:

[If a dialysis patient experiences fatigue, nausea, and a slow heart rate, consider hyperkalemia first.]

After finishing writing, he shoved the pen back into Lin Ye's hand.

"Keep adding to it. That list of yours, you'll start gaining weight tonight."

Lin Ye was holding his pen, but before he could speak, another argument broke out at the triage desk.

A man was holding a bag of medical records, his voice low but clearly angry.

"We don't go to the emergency room, we're going to see Dr. Lin Ye."

Nurse Zhao looked up: "What do you want with him?"

The man slammed the medical record bag onto the stage.

"My mother was diagnosed with a brain hemorrhage here last month, and she was hospitalized, costing over 100,000 yuan. Now she's discharged, but her legs are still weak. I've come to ask, whose responsibility is this?"

Lin Ye turned around.

On the cover of the medical record folder, there was a familiar name.

Zhou Fengying.