Animal Hospital stays calm for the first couple of shifts, then the night turns hostile. Starting on Shift 3, the game throws timed emergencies at you with no warning, and a missed timer means a dead patient. Each emergency has its own clock and its own correct fix, so the difference between a clean shift and a wipe usually comes down to knowing exactly what to do the second the alert appears.
Quick answer: When an emergency alert pops up on the right side of the screen, follow the on-screen arrows to the patient and act before the timer hits zero. Bed Monster (30s) and Death Ritual (40s) are the most urgent. Fire is handled with the extinguisher, the Bed Monster with maple syrup, and the Room 8 monster only by finishing the surgery mini-game.
When emergencies start and how they appear
Emergencies can trigger at any point once you finish your third shift. When one starts, an “Emergencies” tab shows up on the right of the screen with the emergency type and a countdown. The timers are visible through walls, so you can see exactly where to run and how much time is left. If the clock runs out, the patient locked to that emergency dies.
There are seven timed emergencies plus two untimed events, the room fire and the Ambulance Event. Some patients caught in these emergencies can still be anomalies, so stay alert even after you have saved them.
| Emergency | Timer | How to handle it |
|---|---|---|
| Bed Monster | 30 seconds | Equip maple syrup, enter the red zone, feed the monster |
| Death Ritual | 40 seconds | Put out all candles, tase the patient, or use items on candles |
| Monster in Room 8 | 45 seconds | Complete the surgery mini-game (never tase or shoot it) |
| Patient on fire | 60 seconds | Fire extinguisher (instant heal) or hands plus ointment |
| Patient fainted | 60 seconds | Carry to the designated bed (or bin them with no penalty) |
| Critical patient | 100–120 seconds | Full check-in and treatment, not just a bed |
| Room fire | No timer | Use the fire extinguisher before patients walk in |
| Ambulance Event | No timer (Shift 5) | Treat 6 incoming patients, some on fire or critical |
Bed Monster (30 seconds)
This is the shortest timer in the game, so it always comes first when several alerts fire at once. The Bed Monster can appear under any room’s bed and grabs a patient as they walk out, slowly dragging them under. You have 30 seconds to stop it.
The clean fix is to equip maple syrup and step into the red area near the bed. The monster takes the syrup, lets go of the patient, and disappears. If you do not have syrup, interact with the dragged patient to help them break free. If the monster grabs you instead, mash your interact key to escape while it drains your sanity.
Note: the Bed Monster will also go after players and anomalies that wander too close, so never approach it without maple syrup ready.
Death Ritual (40 seconds)
A Death Ritual can hit any occupied room. The first tell is that the door takes longer than normal to open. Inside, the lights are dimmed, the patient floats above the bed surrounded by ritual candles, and the recovery screen shows an error. You have 40 seconds to break it.
There are three ways to end the ritual. You can put out every candle by hand, but each one costs 1 to 3 sanity points, which adds up fast late in a shift. You can tase the patient to break the ritual instantly. Or you can use eyedrops, IV drops, or coffee on the candles, which clears them with zero sanity cost. Once the ritual breaks, the lights return and the patient drops back onto the bed to recover.
Tip: keep a taser charged before Shift 5. When the Ambulance Event floods the hospital, removing a ritual in one click saves time you do not have.
Monster emerging in Room 8 (45 seconds)
This emergency only happens in Room 8, the surgery room. If a patient is recovering there, a purple monster can emerge from them. You have 45 seconds to finish the surgery mini-game, with the steps shown on the blackboard behind the bed. Follow them in order and the monster vanishes while the patient lives.
The one rule that decides this emergency: do not tase or shoot the purple monster. It is directly tied to the patient, so any damage you deal to it kills the patient instantly and forces you to start over. Just complete the surgery.
Patient on fire (60 seconds)
A patient can sprint into the hospital while on fire, panicking and screaming. You have 60 seconds to put the flames out. The fire extinguisher is the best tool by far because it douses the fire fast and heals the burn wounds automatically, so no follow-up is needed.
If you use your hands, the fire eventually goes out, but the patient is left with burn wounds that need ointment, applied either at the check-in window or in a medical room. That extra treatment also has to land inside the same 60-second window. The extinguisher becomes available at the start of Shift 3 and sits in the glass case near the check-in booth, to the right of the Supplies Shop. When it runs out of charge, return it to its spot to refill it to 100 percent.
Watch out: some burning patients are anomalies in disguise, so do not let your guard down once the fire is out.
Patient fainted (60 seconds)
A patient can collapse at the check-in window, after walking into a burning room, or after being shot. However it happens, the fix is the same. Pick them up and carry them to their designated bed within 60 seconds. Placing them on the correct bed stops the timer, and you can treat them normally from there.
There is also an escape hatch. You can throw the fainted patient in the trash, which does not count as a death and skips the treatment process with no penalty. It is not something you want to lean on, but when you are buried under several emergencies at once, the option exists. Fainting patients can also be anomalies, so stay watchful after they hit the bed.
Critical patient (100 to 120 seconds)
A critical patient is the most demanding emergency because a bed alone is not enough. You get 100 to 120 seconds to take them through the full process and into recovery, treatment or surgery included if the room calls for it. Miss the window and they die.
This rarely shows up on its own, but it appears constantly during the Ambulance Event. When the hospital is packed and one or two patients are critical, prioritizing decides the shift. Take the critical patient first if its timer is tight and let the steadier patients wait a moment. A critical patient can also turn out to be an anomaly.
Room fire (no timer)
Any room can randomly catch fire during a shift, whether or not a patient is inside. It is not a timed emergency, but it blocks you from treating anyone in that room and costs 1 sanity per second whenever you stand too close. Grab the fire extinguisher and put it out fast.
You can also smother the flames by hand, but it takes longer and drains more sanity. If a new patient walks into a burning room, they faint on contact. When that happens, get them onto their bed first to stop the faint timer, then deal with the fire. A fire in an already occupied room does not mean the patient or visitor is an anomaly.
The Ambulance Event (Shift 5)
The Ambulance Event is the big multi-emergency scenario, and it first fires on Shift 5. Dr. Harlow announces that an anomaly attack has hit the town, leaving six dead and several injured, tells you to brace for an incoming ambulance, then retreats into his office and leaves you to it.
Six patients pour in at once and take whatever rooms are open, skipping the check-in window. Some arrive already on fire and others show up in critical condition, and any of them can be an anomaly or skinwalker. The music shifts to a tense theme and keeps playing until every emergency in the wave is cleared.
Clearing your first ambulance rewards bonus cash at the end of the shift, and Dr. Harlow warns you that more are coming. From that point, an ambulance arrives every 5 shifts, each wave carrying a growing number of critical patients and paying out bonus cash when the shift ends.
Handling multiple emergencies at once
When two or more alerts stack up, work the shortest timer first. The Bed Monster at 30 seconds is always the top priority, then the Death Ritual at 40 seconds, then the Room 8 monster, and finally the 60-second emergencies. The critical patient gets bumped up the order whenever its clock is already running low.
Walk into every later shift with the fire extinguisher charged and maple syrup in your inventory, since those two items resolve the fastest emergencies in the game. Heading into Shift 5 or beyond, bring a charged taser too, because it clears a death ritual in a single click while you are already juggling a hospital full of patients. Stay on top of the timers, keep your tools ready, and the night shift stays survivable.
