Admitting Officer

Emergency Department
Newton Hospital

13. 09.14

Dear doctor,

Re: Ms Sally McConvelli, Age: 38 years

I am writing to request urgent management and investigation of MS McConville, whose

features are suggestive of acute asthma with possibility of pneumonia.

Upon today’s visit, Ms McConvelle presented with worsening shortness of breath despite
being on antibiotics and prednisolone along with feverishness and unwellness. On
examination, she was dyspnoeic at rest which was evident by high respiratory rate and
laboured breathing. In addition, diffuse wheeze and bilateral basal crepitation were noted on
the chest auscultation. Therefore, nebulization with Ventolin was commenced; however, this
showed no improvement.

Initially, on 10.9.14, Ms McConvelle attended with the deterioration of asthma followed by

upper respiratory tract infection. After a day, she visited again with a worsening of her
condition. On examination, he was pyrexic, mild techypnoeic, and tachycardic with extensive
wheeze on the chest. Considering infective exacerbation of asthma, amoxicillin and
prednisolone were prescribed.

Ms McConvelle has no known allergy and she has had hypertension, depression, and
cholecystectomy. Her regular meditations include Ventolin inhaler, fluticasone inhaler,
ramipril, and paroxetine.

In view of the above, would you please manage her condition immediately with the
necessary investigation, if appropriate. Should there be any queries, please do not hesitate
to contact me.

Yours sincerely,
Doctor.