ABSTRACT
An 82-year-old man presented to the emergency department complaining of shortness of breath on exertion, orthopnoea and wheeze. He was a vague historian and was clearly very confused. He did tell the team that he was an ex-smoker, had previously consumed alcohol to excess, and thought that his general practitioner (GP) had stopped a ‘water tablet’ over the preceding month. Documents on the trust electronic patient record system showed that he had a past history of atrial fibrillation, hypertension, angina and vascular dementia, but no further medical records were available. There were no details for a next-of-kin from whom to take a more complete history. It was a Friday evening and the emergency department team was therefore unable to contact the patient's GP.
