60-year-old male, 2 months in hospital for H1N1 influenza requiring ECMO complicated by ischaemic bowel, acute kidney injury and critical illness weakness syndrome. Clinical findings included flaccid weakness, more so in the upper than lower limbs: spontaneous respiration via tracheostomy with small tidal volumes and poor cough with copious secretions; abdominal wound with ileostomy.
Candidates were asked to examine him with a view to assessing his suitability for ward transfer and decannulation of the tracheostomy.