It's a rainy Saturday night, and your urban emergency department is starting to get busy. There are multiple patients who have been brought in by EMS on backboards. As a trio of residents gets ready to roll one of the patients, the one at the head of the bed tells the others to be careful because the patient has vomited and urinated on himself. You tell the residents to hold off rolling him for a second. The patient is a 62-year-old male back-boarded, c-collared, in a ripped suit. You ask him how he's feeling. He says he's OK, but his left leg seems “funny.” You ask him to try to lift it off the bed, but he can not. He says he has pain, and he asks you if he is going to be OK. After reassuring the patient, you tell the residents to move the patient to the trauma room as you begin to prioritize your concerns with this patient. You are also thankful you had the presence of mind to consider spinal injury in this patient.