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

"Choose a date?"

Qin Hai held the prescription paper in his hand.

The corners of the paper were softened by sweat, and the creases were already frayed.

No one in the red zone responded to those two words.

The monitor is still ringing.

Blood oxygen 93.

Heart rate 141.

After the patient was intubated, his chest movements became more stable, but the swelling under his chin did not subside. Instead, it pressed down along his neck, making his collar feel tight.

Nurse Zhao put the suction tube back and glanced at the head of the bed.

"And he drools a lot."

The oral and maxillofacial surgeon took the prescription, glanced at it, and frowned even more deeply.

"Did you go to the dentist this afternoon?"

The woman stood at the foot of the bed, her hand still resting on the edge of the signing board.

"He went there. He said his tooth hurt and his face was a little swollen. They said it was an inflamed wisdom tooth, and he should take some medicine first and then have it cut open tomorrow."

Her voice trailed off at the end.

"I thought I could wait."

The ENT doctor did not respond to her statement.

He stared at the patient's neck.

"The swelling has gone down."

After the anesthesiologist secured the tubing, he checked the monitor.

"Establishing the airway first doesn't guarantee safety. A monitor will be present during transport; I'll be with you for a while."

Lin Ye paused for a moment while holding the pen.

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

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

[Secondary risk: infection spread, abscess extent unknown.]

[Public evidence: Unreduced heart rate, elevated body temperature, downward displacement of anterior neck swelling, pending inflammatory markers, and significant airway edema.]

Lin Ye pressed down the text frame and looked back at the notes on the bedside table.

Body temperature 38.7 degrees Celsius.

Blood pressure 139.88.

Blood oxygen 93.

My heart rate still hasn't come down.

He reported the numbers to Qin Hai.

"Body temperature 38.7 degrees Celsius, heart rate around 140. Swelling in the front of the neck is half a finger less than when entering the red zone, and the collar is already pushed up. Blood oxygen 93 after the airway was established, but it did not continue to rise."

Qin Hai didn't look up.

Write it clearly.

He turned to an oral and maxillofacial surgeon.

"Can I watch the movie?"

Oral and maxillofacial surgeons see anesthesiologists.

The anesthesiologist checked the breathing tubes again.

"They're better now than before. We can't delay any longer. Bring oxygen, suction, and life-saving medications; nobody touches the tubing."

The ENT doctor added a comment.

"When you get to the CT scan, don't bend your neck back and forth to get proper positioning."

Nurse Zhao has already started ordering.

Oxygen cylinder.

Attractor.

Monitoring line.

Backup piping.

Emergency medication.

As she made her order, she spoke to the young nurse.

"You push the IV stand, I'll watch the tubing. Family members, don't follow us into the CT room, wait at the door."

The woman immediately stepped forward.

"I'm not going in, I'll stay right at the door. Doctor, is he able to breathe now?"

Qin Hai put the prescription paper into the medical record folder.

Being able to breathe doesn't mean you're okay.

The woman stopped.

Qin Hai's voice was not loud.

"The infection around the tooth root is spreading deep into the neck, and blocking the airway is only the first step. Whether there is pus inside and how it is spreading needs to be determined by looking at the X-ray."

The woman's throat moved slightly.

"Will it be enough to cut it tomorrow?"

The oral and maxillofacial surgeon took over directly.

"It's not about tomorrow. If the scans show a deep abscess, then it needs to be treated."

As the stretcher was being pushed into the CT room, the emergency bell at the entrance to the red zone finally stopped.

But Ke Ren didn't relax.

A faint hiss is heard when the valve of the oxygen cylinder is turned on.

The monitor was fixed to the side of the bed, and the numbers swayed with the trolley.

Lin Ye walked beside him, one hand pressing down on the recorder, the other not touching the tubing.

He only focuses on three things.

Blood oxygen.

Heart rate.

The swelling on the front of the neck.

The on-duty imaging staff in the CT room were already waiting at the door.

He saw the number of people beside the bed, but swallowed the words that were on the tip of his tongue.

"Enhancement?"

The oral and maxillofacial surgeon handed over the application form.

"Strengthen the neck. Examine the submandibular region, floor of the mouth, parapharyngeal region, and deep neck spaces. Move quickly."

The videographer nodded.

"Kidney function has just recovered, and creatinine levels are normal."

Upon hearing this, Lin Ye made up for the time of the inspection report.

Before the blood collection tubes were even fully labeled, the testing hotline called the red zone.

High white blood cell count.

High C-reactive protein levels.

Procalcitonin levels also increased.

Lactic acid isn't scary, but it doesn't make you feel comfortable.

Qin Hai only asked one question on the phone.

"The data is sent to electronic medical records, and the paper results are sent to the red zone."

He hung up the phone and looked at Lin Ye.

"Don't write 'already diagnosed.' Write 'suspected deep infection, awaiting imaging confirmation.'"

Lin Ye nodded.

"Know."

The CT room was very cold.

When the patient was transferred to the examination bed, Nurse Zhao kept pressing on the tubing connection with her hand.

"Don't break this one."

The young nurse moved the IV stand forward half a step.

The anesthesiologist stood at the head of the bed, his eyes never leaving the patient's chest.

The imaging technicians pushed the bed in.

"Scan location first."

The machine started up, and a humming sound came from inside.

The woman stood outside the lead door, clutching the unopened bag of anti-inflammatory medicine in her hand.

The bag was crumpled from her grip.

She suddenly asked Nurse Zhao in a low voice.

"Can I still take this medicine?"

Nurse Zhao glanced at her.

"Don't think about this bag of medicine now. The doctor didn't tell you to take it, so don't put anything in your mouth."

The woman stuffed the medicine bag back into her bag, but stopped halfway through zipping it up.

"He told me this afternoon that his gums were swollen."

No one joined her in criticizing the clinic.

The machines inside are still running.

The cameraman's hand was still on the mouse.

The film came out very quickly.

The radiologist didn't wait for the complete report to be printed before loading the images onto the workstation.

Oral and maxillofacial surgeons and otolaryngologists gathered around.

On the screen, there was a swollen area under the jaw and at the floor of the mouth.

There are also several low-density areas nearby.

The radiologist clicked with the mouse.

"It looks like an abscess has formed here. The parapharyngeal space is also involved. There is significant swelling in the deep soft tissues of the neck."

He cut down to the next layer.

"These small gas shadows need to be noted. There is a risk of them spreading downwards, but the report cannot directly state mediastinitis at this time."

The oral and maxillofacial surgeon's face darkened.

That's enough.

The ENT doctor also turned his attention away from the screen.

"We can't delay."

Qin Hai asked a very short question.

"Operating room?"

The oral and maxillofacial surgeon has already taken out his phone.

"I'm calling my superior. Emergency incision and drainage, first deal with the floor of the mouth and submandibular region, then check the parapharyngeal region along with the ear, nose, and throat. Continue with the airway management on the anesthesia side."

The anesthesiologist glanced at the patient.

"The tubes are still there; transferring them to the operating room is better than leaving them here."

Upon hearing the word "operating room," the woman took a step forward.

"Didn't you say you were just going to do a check-up? Why do you need surgery now?"

The oral and maxillofacial surgeon turned the screen to her without using too many technical terms.

"Look at this piece."

He pointed to the area on the screen that was a different color.

"The infection around the tooth didn't stop at the gums. It spread downwards, into the neck. Now we need to drain the pus, control the infection, and protect the airway. This is not an outpatient tooth extraction."

The woman stared at the screen.

She actually couldn't understand it.

But that vast expanse of gray shadows was colder than any "it's dangerous" statement.

She finally zipped up the zipper in her hand.

"They said this afternoon that we'll cut it tomorrow."

The ENT doctor looked at her.

"He could still speak in the afternoon. Now he can't make a sound; his airway has just been recovered."

After saying that, the woman never asked about tomorrow again.

Lin Ye added a few timestamps to the record.

At 7:42 PM, difficult airway management is in progress.

After the airway was established, the blood oxygen level was 93%.

At 8:06 PM, a contrast-enhanced CT scan of the neck was performed with monitoring.

At 8:18 PM, preliminary imaging suggested infection in the submandibular region, floor of the mouth, parapharynx, and deep neck, with possible abscess formation and a risk of downward spread.

At 8:22, the Department of Oral and Maxillofacial Surgery, Department of Otolaryngology, and Department of Anesthesiology assessed the situation and decided to proceed with emergency incision and drainage.

As he finished writing, the tip of his pen pressed a mark into the back of the paper.

The system window popped up again.

The chain of evidence has been established.

[Source of infection control: Incomplete.]

[Transportation risk: Persistent.]

Lin Ye did not look up.

Qin Hai has already called the operating room.

"Deep neck infection, airway established, prepare for emergency incision and drainage. The patient is currently at the CT room entrance, transfer immediately."

There was a two-second pause on the other end of the phone.

"The operating room can be opened. The anesthesiologist and specialists can come together."

Qin Hai hung up the phone and turned to look at the flatbed cart.

"Walk."

The patient's blood oxygen level remained stable at 93%.

My heart rate, however, remained at 140.

The flatbed cart was pushed back towards the elevator.

The woman followed behind, and after taking two steps, she glanced again at the prescription paper tucked inside the medical record.

Pericoronitis of the lower right wisdom tooth.

To be handled at a later date.

The elevator doors opened.

Nurse Zhao held the oxygen cylinder.

The anesthesiologist is watching the tubing.

The oral and maxillofacial surgeon lowered his voice on the phone.

"Don't wait until tomorrow morning. Start driving as soon as people arrive."