Overcrowding

A 62 year-old male presents to the emergency department (ED) with low back pain after a mechanical fall as he slipped on a puddle of water. After a 14 hour wait, he finally gets moved to an exam room. Upon examination you notice lumbar spine tenderness with inability to flex his left thigh. A CT of his lumbar spine demonstrates a L2 vertebral body fracture with retropulsion. The patient has to be transferred to another hospital due to unavailability of neurosurgical services. Delays in care were mostly due to boarding patients and lack of staff.