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Inadequate pain management in the emergency department has received much attention recently, including by the Joint Commission. ED crowding is one of the many postulated contributors to inadequate or delayed emergency pain management. In a retrospective study of nearly 14,000 patients who presented to an urban ED with severe pain (score of 9 or 10 on a 10-point scale), the authors examined whether ED crowding contributed to delayed pain management. The two measures of delay were administration of pain medication more than 1 hour after triage and administration more than 1 hour after arrival in a treatment area. Measures of crowding were ED occupancy, total number of patients in the waiting room, and aggregate number of patient hours (length…