- 69-year-old female with a history of recurrent falls, two weeks in ICU following a fall resulting in left-sided rib fractures, pneumothorax and surgical emphysema. Clinical findings included cachexia, reduced breath sounds left base and the presence of a tracheostomy. Candidates were told that she had presented with respiratory failure following a fall and were asked to examine her and assess why she was failing to wean. Discussion points included interpretation of investigations and management of weaning.