Emergency Department Boarding Stories

Table of Contents

Severe overcrowding


"Severe overcrowding in ED (HOLDS) and waiting room (WR) (2nd to no ED beds). Patient in the waiting for six to eight hours heard calling out from the restroom in distress. Patient found diaphoretic and increased work of breathing (WOB). Patient coded while being transferred to wheelchair from toilet. ROSC* achieved in the ED.

Severe overcrowding in ED (holds) and waiting room (second to no ED beds). Patient with chest pain in the waiting room. Physician presented to the waiting room given ongoing pain - during interview, patient coded.Found to have coronary artery dissection. ROSC achieved but pt has depressed EF of 30-40%.

60s yo presented to ED with c/o h/o exertional chest pain (CP) - no CP in the ED. No ED beds 2nd to ED Hold occupying >90% of ED beds. Patient did not want to wait for ED bed (as physician could not estimate when bed would be available) so pt left with plan to get one to two day follow up with Cards. Patient f/u set for 10 days out. Presented day six with STEMI**."

*[ROSC=Return of spontaneous circulation, or heart beat resuming]

**[An ST-elevation myocardial infarction (STEMI) is a type of heart attack that is more serious and has a greater risk of serious complications and death.]

Killing the morale

We have approximately 45 beds but some are dedicated to inpatient holds, and we had 29 boarders the ...

Hopeless and beaten down

With the current staffing crisis on a recent shift we were unable to staff 30% of our beds.


We are a large-volume ED, seeing 350-400 patients per day. When we have over 50% of our ED beds full...

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