Last week I attended a male in his 60,s with "Abdo pains". This was on blues and twos. When we got to the chaps address he and his wife both said...."The doctors just left not more than a minute before you arrived." So I asked if the doctor had left a letter?...."No".... Did the doctor say what was wrong with you?...."No" So what did the doctor do exactly?...."He had a feel of my stomach and said I should go to hospital." And at no time did he say what might be happening or do any other examination of you?...."No." Thanks very much doctor.... So we started a full exam gaining base line obs and gaining a history..... 3 day gradual onset of abdo pains/vomitted once today/loss of appetite/not sleeping/looks pale/not on any meds/no previous medical history/smokes maybe twenty a day/drinks very occassionaly. Pulse...110/Resps...20/Blood Pressure....120 over 68/Oxygen Saturation...78% on air....84% on oxygen Examination of stomach....slightly distended. Upon placing hand over umbilical area..."boom, boom, boom, boom, boom etc" Oh oh! I arranged for this chap to be seen straight away in resus and we blued him in. Later found out that he was in theatre within the hour to repair an 11cm AAA! (abdominal aortic aneurism) Now if I had missed this and this chap had died....I would have been hauled over the coals and probably sacked. The doctor on the other hand would have been let off scot free! One rule for them and one rule for us.....