1
Draw ambulance dice
First Player draws 3 dice from the bag for each ambulance and rolls them
2
Reroll invalid results
Reroll any dice showing 1 or 6 until all show values 2-5
3
Fill ambulances
Place dice one by one starting with lowest values, filling ambulance 1 first then proceeding to higher numbered ambulances
4
Resolve tied dice placement
When multiple dice share the same value but different colors, the player to the right of First Player decides placement order
5
Select ambulances
Starting with First Player clockwise, each player takes one filled ambulance (First Player may not select ambulance 1)
6
Award lowest ambulance bonus
Player who claimed lowest-numbered ambulance takes a Blood bag token and the First Player token
7
Return unclaimed dice
Return patient dice from the unclaimed ambulance to the bag
8
Place new patients
Move patients from your ambulance into empty untreated ward spaces (top row)
9
Handle overcrowding
If insufficient space for new patients, remove existing patients as fatalities (take Fatality token, return die to bag)
10
Claim improvements in order
In ambulance number order (lowest first), each player takes either one Department tile or one Specialist card from the display
11
Attach Department tiles
Place new tiles touching another department; exact location doesn't matter
12
Gain Specialist meeples
When taking a Specialist card, take the matching colored meeple from supply and place on the card
13
Optional discard for Blood bag
After all players take improvements, each may return one improvement to bottom of its stack to gain 1 Blood bag token
14
Activate departments
Place available nurses or specialists one at a time into empty departments to trigger healing effects
15
Follow activation rules
Each meeple can only be placed once per round; each department can only be activated once per round
16
Heal patients
When healed, increase patient die value by one step and move from untreated to treated space (bottom row) on first healing
17
Continue treating treated patients
Treated patients can receive additional healing effects in the same round
18
Discharge fully healed patients
When a patient reaches value 7 or more, immediately move to discharged area
19
Trigger specialist abilities
When using a specialist, resolve department effect first, then optionally trigger the specialist's special ability once
20
Use Blood bag tokens
Spend tokens during activation to heal any patient 1 step OR temporarily change any die's color for the remainder of the phase
21
Deteriorate untreated patients
Each patient still in untreated spaces (top row) has their value reduced by 1
22
Record fatalities
If any patient drops to value 0 or below, return die to bag and take a Fatality token for your morgue
23
Score discharged patients
Count discharged patients and score points: 1=1pt, 2=3pts, 3=5pts, 4=7pts, 5=9pts, 6=11pts, 7=14pts, 8=17pts, 9=21pts, 10=25pts, 11=30pts, 12=35pts
24
Return discharged dice
Return all scored discharged patients to the bag
25
Score empty wards bonus
Score 5 additional points if all four wards are completely empty
26
Reset meeples
Move all nurses back to Nurses' Station and specialists back to their cards
27
Reset patients
Return all treated patients to untreated ward spaces
28
Return ambulance
Return your ambulance to the center of the table
29
Advance round marker
First Player rotates round marker to show next round number
30
Refresh display
First Player moves unclaimed improvements face-down to bottom of stacks and reveals new tiles/cards as per setup
