The Emergency Department at Children’s Hospital of Michigan has rapidly grown over the past five years. Over the past two years the annual volume has approached 85,000. The ED has 51 beds and is divided into nine pods. A pod is a group of rooms where a team of health care professionals care for the patients in that particular area. In the octopus/dolphin pod one pediatric emergency medicine attending, one pediatric emergency medicine fellow and two residents care for the patients. A three bed trauma bay is fully equipped to manage multiple critically injured/ill patients. Pediatric emergency medicine fellows exclusively work in the octopus/dolphin area because the sickest medical and trauma patients are placed there. One pod, angelfish/clownfish is the low acuity pod where fast track patients are cared for.