Unspecified hospital in Adelaide

59-year-old male, day 25 ICU, having presented with pneumonia on a background of COAD, anxiety and alcoholism. Clinical findings included and alert and co-operative patient with evidence of muscle wasting with preserved strength, an in situ tracheostomy with subglottic suction and reduced breath sounds at the bases.

Candidates were directed to assess the patient and formulate a management plan including the consideration for decannulation.

Discussion points included the management of pulmonary haemorrhage, and the significance of pseudomonas colonisation.