Investigations should be led by the presenting complaint and any other underlying issues uncovered during assessment. It must be kept in mind that homeless and vulnerable patients are often not appropriate for ambulatory pathways e.g. returning for doppler to investigate for DVT, and so investigations should be expedited where possible (1).

RCEM suggests that routine ED HIV testing should be considered in areas where the local HIV prevalence is 2/1000 or greater as long as appropriate systems and funding are available to support the programme (22).

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