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

The elevator doors had just opened when the emergency call bell from the red zone slammed into them.

Lin Ye followed Qin Hai out.

The flatbed cart was stuck at the entrance to the red zone, and the person did not lie down.

The 32-year-old man sat half-sitting on the edge of the bed, his body hunched forward, an oxygen mask on his face, his throat tight with each breath.

His neck is swollen in an unusual way.

His chin was taut, his skin stretched and shiny. Saliva dripped from the corners of his mouth, staining his clothes on his chest.

Nurse Zhao held the suction tube, keeping her voice down.

"Don't lie down, sit up."

The family member was still clutching a bag of anti-inflammatory medication prescribed by the dental clinic.

When she saw Qin Hai, she immediately pushed her way forward.

"Doctor, he just has a toothache. He could still talk yesterday. Can you give him an IV drip of anti-inflammatory medication first? He's having trouble sitting."

Qin Hai didn't look at the medicine bag.

He first looked at the patient's mouth.

The mouth can only open a crack, the tongue is pushed upwards, and the sound leaks out of the throat, unable to form words.

"Don't let him lie flat."

Qin Hai kept the family members at the foot of the bed.

"It's not about the pain, it's about the anger I can't get over."

The woman froze.

"How can a toothache cause such severe anger?"

Nurse Zhao placed the suction tube close to the corner of the patient's mouth.

He couldn't even swallow his saliva.

This statement is more effective than any explanation.

The medicine bag in the woman's hand suddenly drooped.

Lin Ye stood to the side of the stretcher without touching the patient's head and neck.

The blood oxygen level on the monitor was 92%.

Heart rate 132.

Blood pressure 148-192.

The oxygen flow rate was already turned up, but the blood oxygen level only briefly reached 93 before dropping back down to 92.

A blue text box popped up at the edge of the field of vision.

Key risk: Upper airway obstruction.

[The following were disclosed: history of dental infection, anterior neck swelling, limited mouth opening, difficulty swallowing, difficulty speaking, and decreased blood oxygenation.]

Lin Ye shifted his gaze from the text box back to the monitor.

He listed out the items that could be placed on the table.

"I've had a toothache for two days, and tonight I'm having trouble breathing. I have difficulty opening my mouth, I'm drooling, and I'm having trouble speaking. After receiving oxygen while sitting, my blood oxygen level is between 92 and 93. The swelling in the front of my neck has extended down to below my jaw."

Qin Hai only replied with two words.

Write it down.

Sun Zhiqiang had already brought the ambulance to the bedside.

"I called the anesthesiology department, the ENT department is on their way, and the oral and maxillofacial surgery department just connected and said they'd be there in five minutes."

Qin Hai hung the stethoscope on his wrist.

"Draw an IV first. Perform routine blood tests, inflammatory markers, liver and kidney function tests, electrolytes, coagulation tests, and blood cultures. Prepare antibiotics now, and we'll decide on them together when the specialist arrives."

Sun Zhiqiang brought the ambulance to a stop.

"What about the CT scan?"

Qin Hai glanced at the patient.

"If the airway isn't properly secured, even the clearest X-ray won't help."

The patient suddenly raised his hand and grabbed the edge of the oxygen mask, as if trying to tear it off.

Nurse Zhao held down his wrist.

"Don't pick them. You'll breathe even more if you do."

The patient managed to squeeze out a single word.

"block."

The rest was completely drowned out by the sound of breath.

The family members turned pale.

"He, he said it was blocked."

Qin Hai's gaze fell on her face.

"So now don't let him lie down, don't give him water, don't let him rinse his mouth, and don't force his mouth open to look at his teeth."

The woman nodded immediately.

"I won't touch it, I won't touch it."

The sound of wheels stopped outside the red zone gate.

The anesthesiologist arrived first.

He entered without asking what was wrong, and first stood in front of the patient, looking at the rise and fall of the chest, and then at the swelling under the chin.

"Can you speak?"

The patient opened his mouth.

No words appeared.

The anesthesiologist pushed the airway cart next to the bed.

"Difficult airway. Don't lay it flat."

He looked at Qin Hai.

"Call the ENT department quickly. The oral and maxillofacial surgery department shouldn't wait for the scans either; check the source of infection at the bedside first. Intubation might be difficult; we need to be prepared for both possibilities."

Qin Hai picked up the landline phone at the nurses' station.

"Red zone. The person can't speak, can't open their mouth, and their neck is swollen. Bring something that can treat their airway."

As soon as those words were spoken, the positions within the red zone changed.

Nurse Zhao dragged the suction bottle closer.

Another nurse tore open the packaging of the indwelling needle.

Sun Zhiqiang moved the family members half a step away.

"Stand here, don't block the head of the bed. You'll need to sign something later; someone will explain it to you."

The woman's eyes immediately reddened.

"What do we need to sign? Doesn't he have a toothache?"

The anesthesiologist did not bypass the procedure.

"It's not just a simple toothache now. There's swelling in his neck, which might be narrowing his airway. First, make sure he can breathe, then we'll investigate where the infection came from."

The woman looked at the patient.

A layer of white mist quickly rose inside the oxygen mask and then quickly dissipated.

She stuffed the medicine bag into her bag.

"I'll sign."

When the on-call oral and maxillofacial surgeon arrived, the otolaryngologist also entered at almost the same time.

Neither of them tried to force the patient to admit it.

Oral and maxillofacial surgeons only allow patients to open as much as they can.

The patient was only made a small incision.

An unpleasant smell mixed with saliva came out.

The oral and maxillofacial surgeon immediately stepped back half a step.

"Elevated floor of mouth, limited mouth opening, and swelling under the jaw. Deep odontogenic infection is highly likely."

The ENT doctor has already prepared the fiberoptic endoscope.

"First check the upper airway. Sit down, don't lean back."

The anesthesiologist looked at Qin Hai.

"If you can get through, try to get through. If you can't, prepare for a tracheotomy. Family members need to sign the consent form quickly."

The woman had just taken the signature board when she made her first mark outside the designated area.

Nurse Zhao straightened the pen.

"Write down his name first. The doctor is saving his breath, not having you choose to have a tooth extracted right now."

The woman's hands trembled, but she still signed her name.

When the signature board was handed back, the patient suddenly took a deep breath.

The voice has changed.

I was feeling down just now.

This breath seemed stuck in a narrow tube, producing a sharp, piercing sound.

Nurse Zhao's hand stopped on the suction bottle switch.

"Director Qin, your voice has changed."

Qin Hai pressed down on the flatbed railing.

"Don't wait."

The anesthesiologist has already set up the endoscope.

"Keep supplying oxygen, and keep up with the attraction."

The ENT doctor stood on the other side.

"Keep the tracheotomy kit handy."

The oral and maxillofacial surgeon stabilized the mandible, preventing it from tilting backward.

"Don't dodge, inhale with me."

When the fiberscope was inserted, the blood oxygen level dropped from 92 to 90.

Lin Ye pressed the tip of his pen against the recording paper.

He wanted to take a step forward, but then stopped.

This is not a position he can take.

All he could do was record the time, the values, the people present, and every change.

"Eighty-nine."

The nurses are counting off.

Eighty-eight.

The anesthesiologist's voice came through the mask.

"The area in front of the glottis is severely swollen."

The ENT doctor has already opened the sterilization pack.

Qin Hai stood behind the head of the bed, his voice not loud.

"If it passes, it passes; if it doesn't, cut it off immediately."

Two more seconds passed.

The monitor screamed.

Blood oxygen 86.

The anesthesiologist did not look up.

"Guide wire".

The nurse handed the items over.

Nurse Zhao sucked away the saliva and secretions.

Oral and maxillofacial surgeons stabilize the mandible.

The ENT doctor's hand remained beside the disinfection area on the front of the neck, without moving away.

Lin Ye heard the sound of his pen tip scraping against the paper.

7:42 PM.

Difficult airway management in progress.

Blood oxygen 86.

Anesthesiologists, otolaryngologists, and oral and maxillofacial surgeons were present.

The next second, the anesthesiologist's shoulders relaxed a little.

"It's in."

Nurse Zhao immediately checked the monitoring.

"Eighty-eight, eighty-nine, ninety-one."

Blood oxygen levels gradually climbed upwards.

The patient's chest muscles, which were desperately pushing upwards, slowed down.

The woman covered her mouth at the foot of the bed, not daring to make a sound.

The anesthesiologist secures the tube.

"Don't relax yet. The airway has only been saved for now. The infection is still there, and the extent of the abscess needs to be checked. It may be necessary to incise and drain it later."

An oral and maxillofacial surgeon looks at the swelling in the front of the patient's neck.

"Once the vital signs stabilize a bit, we'll do a contrast-enhanced CT scan of the neck. We'll start with infection control first, and then prepare the operating room."

Lin Ye wrote the last sentence into the record.

The airway has been established.

Blood oxygen levels rose to 93%.

The extent of the infection is to be further assessed.

The blue text box jumped slightly.

[Current Risk: Upper airway obstruction - temporarily addressed.]

[Subsequent risks: spread of infection, unclear extent of abscess.]

Lin Ye did not stop writing.

At the entrance to the red zone, the young nurse ran back, holding a registration slip and a prescription from a small dental clinic.

She handed the prescription to Qin Hai.

"Director Qin, the family member said he went to the dentist this afternoon. They told him to come back tomorrow for an incision, and to start taking medication tonight."

Qin Hai took the thin prescription paper.

The corner of the paper was already softened by sweat.

There was a line of text written on it.

Pericoronitis of the lower right wisdom tooth.

To be handled at a later date.

Qin Hai's face darkened as he looked at those four words.

"Choose a date?"

No one responded in the red zone.

The blood oxygen level on the monitor was still at 93%.

The patient's neck was swollen, but the swelling was gradually spreading down to below the collar.