Unspecified hospital in Adelaide

44-year-old female, day 45 ICU, who presented with fever, shortness of breath and cough seven weeks earlier. Clinical findings included right-sided pleural effusion, a thoracostomy wound, ECMO scars in the groin, a recent decannulated tracheostomy site, a tender abdomen and significant muscle weakness.

Candidates were directed to examine her with respect to readiness for the ward and management plans for ongoing intensive care problems.

Discussion points included the differential diagnosis and investigation plan of muscle weakness in this setting, as well as the management of the patients respiratory function and rehabilitation.