It's 6pm in the ED on a sunny summer afternoon- you're working as a single coverage physician at a level 3 trauma center. You are noticing an uptrend in the trauma patients being brought in over the past few hours. While log rolling yet another patient, an EMS provider tells you that they have been making runs nonstop- all of the hospitals downtown are overloaded, and it doesn't look like it will slow down anytime soon. Your modest trauma bay is already full, and you're starting to sweat about the state of the department- there are 4 patients in the pod you haven't even seen yet, 2 with abnormal vital signs.

The in house radiologist has left for the day, and CT reports are being faxed from the tele-radiologist, but seem to be taking an eternity. You are trying to decide which patients need to be transferred out when your latest patient, Jake, a drunk ATV rollover, rips off his c-collar and throws it at you. You begin to review some of the spine imaging, hoping to get an idea of who may need a higher level of care, trying to find a way to decompress the department. You stare into the computer screen, eyes stinging from salty sweat as you scroll through the many shades of grey.

You're a bit rusty on your radiology skills, and you can already hear more sirens approaching the bay doors...