Confusion with consciousness rolls

I'm finding it tricky to understand how often you make consciousness
rolls in Trail of Cthulhu. I understand that you have to make them the
first time you drop below 1 and become hurt, and again when you drop
below -5 and become seriously wounded.

What happens though if you are already hurt, say with Health -3, and
you lose another Health point to take you to -4? You are still hurt, but
do you make a consciousness roll?

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