Flank pain, haematuria and a rash

It is a typically chaotic shift in the local hospital’s emergency department where you regularly work as a GP. As usual, inpatient beds are not available and the log jam puts the emergency department into a shambles.

The department’s computer system shows your first patient has been classified at triage as a category 3, i.e. requiring to be seen within 30 minutes. The only place available for examination is a couch – not a bed – in the treatment cubicles, which are usually used for dealing with the walking wounded, such as those with lacerations. You promise the nurse you will be quick as when these treatment rooms get jammed up with admissions the ship is well on its way down.