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So far today the accident and emergency department at Queen Elizabeth Hospital Birmingham has treated a total of 235 patients.
Today is unlikely to beat Monday's hospital record of 325 patients in 24 hours.
After a lot of tests Clare Stajlla headed home from the Queen Elizabeth A&E.
She had suffered a bite but was allergic to antibiotics - doctors at the A&E told her she could stay overnight for treatment and observation, but that it could mean up to a week in hospital.
She decided instead to wait and hope the bite healed without the need to be admitted and to avoid the possible side effects - which included kidney failure at the extreme end.
Clare had spent a little over four hours in A&E from check-in to leaving this evening.
Sister June Sargeant, who ITV News met at the end of her nightshift this morning, is back on shift and currently too busy to talk.
This evening her colleague said a surge of major trauma patients would make for a hectic overnight period in the A&E unit.
Aysha Rafi has left A&E with a box of medication within 40 minutes of arriving at QEHB.
She came to the hospital with a referral for a bite or sting on her foot and says her decision to go to A&E was the right one.
Rhianna Wade came in to A&E last week with chest pain. She had called an ambulance and was seen treated and discharged within four hours.
This time she walked in to the minor injuries clinic and was waiting for half an hour to be seen.
She said she wasn't sure what would happen next or when she would be seen.
Aysha Rafi had a sting or a bite - she is not sure which - on her foot on Friday.
Over the weekend she noticed it swell up and by Tuesday it was throbbing to the point of severe discomfort.
This afternoon she went to a walk-in service which is part of a Boots pharmacy in Birmingham city centre.
Nurses there said she should come to A&E because the swelling was moving around the foot and away from the initial sting.
Aysha is now waiting to see a triage nurse.
Joanne Goddard called 999 after suffering from severe sunburn for three days - she had been out enjoying the good weather over the weekend.
Joanne said she could not walk because her legs were so badly burned and that she was in a huge amount of pain.
When asked if she had considered calling the new 111 number she said she had no idea what it was and would have been unlikely to use it.
Joanne had spoken to her GP but said that the surgery had been unhelpful and told her to use cream, which she had done, but that it made no difference so she called for an ambulance.
Three ambulances are now lined up outside the major trauma entrance of the Queen Elizabeth Hospital A&E department having recently deposited their patients.
An 82-year-old woman who had come to A&E because she wasn't satisfied with her GP's treatment said staff here have told her she has a possible blood clot in her leg.
She earlier told ITV News that her doctor had advised treating her leg with aqueous cream but she had not seen an improvement in her condition.
She now has an appointment to see a specialist at the hospital tomorrow and is much happier with how her leg is being treated.
Mel Brown has just come to the end of her shift as clinical lead nurse for the trauma care and resuscitation team.
She says the past two days - on course to be the busiest in the unit's short history - show what strain the hospital could be under this summer.
"And it's not even the holidays yet," she adds.
The combination of GP referrals and patients coming straight to A&E with the expectation of a quick fix only adds to the pressure on resources.
"In some ways we're a victim of our own success," says Mel.
And the build up of major trauma patients arriving in the last few hours means the night shift will be even busier.
Latest ITV News reports
A&E departments across the country are having what some people call "a challenging" time and others say is a full-blown crisis.
Queen Elizabeth Hospital Birmingham is a major trauma centre treating the most severely injured casualties from across the Midlands.