"We have a 44 bed ED and routinely are boarding 40 patients and trying to see all the usual ER patients in whatever space is left. We’ve done lateral canthotomies (more than once!) in the hallway, paracentesis in the hallway, rectal exams in the hallway. We’ve had delayed STEMI recognition by three hours. Our ambulance crews sit in the ambulance bay until the patient can get a spot in the ER. Sometimes up to three to four hours. I once admitted a patient from the back of the ambulance. I also sent home a 78yo with scalp laceration after a fall from the back of the ambulance. They filed a complaint as to why they were getting an ER bill when they never even set foot on hospital property. Yes, boarding is bad."