Yup, gotta agree with Dave and Sundowner. When you are covered up like that, you don't have time to second guess or overthink yourself-you've got to do it right the first time. Thank goodness days like that aren't the norm-most places. I think the thing that disturbed me the most was having to keep admitted people in the ER, tying up beds and personnel. No way is that fair! There was one 4th of July I was charge in our 7 bed and 1 obs ER. It was about 6:30 p, and I was beginning to get excited-we had been full all day, including 3 beds in the hall, and had serious stuff that required a lot of admits, and time-consuming stuff like suturing, that was labor-intensive for our 1 doc, thus tying up beds. I knew the evening folks would be there in 15-20 min. I got a call to go out and triage, and there was a man with an approx. 5 inch lac across the top of his head, from ear to ear. He was wearing a wet bathing suit, period. Could smell ETOH from 4 feet away-asked have you been drinking? 3 beers, he answered-wife said, has been drinking peppermint schnaaps all day-more like it. Asked what happened-dove off his houseboat, and hit a boatramp-gravel imbedded in lac-running to get c-collar and find 2 available hands to hold c-spine, wondering, where am I going to put this one? On the way, radio goes off, I have to answer, acute MI coming in-already have an admit in the room we primarily use for that, all others full. Where...came back with collar and hands, got them in place, put guy in W/C while beds being shuffled. Went to meet ambulance, saw double doors tohall open, in walked a woman, accomp. by a man, bra tied around her right lower leg. What...? We were hiking the AT, and she was bitten by a copperhead-the only thing I had to use as a tourniquet was her bra. Omigod! More shuffling beds, and praying-need more beds! Need LOTS more hands! More folks to triage. Finally, evening folks begin to appear-one sent to triage while I gave report to charge nurse, as we were doing a rundown of the everchanging board, double doors to hall open, man and woman walk through (dejavu all over again!), I say what...? They say, hiking the AT, stopped at a stream, a raccoon bit BOTH of us, several times, we think he was rabid. Stayed for an hr. to help the evening folks get a handle. By then, all of the drunks from the day were beginning to arrive with various complaints. Happy 4th!