Emma Johnson is an 11-year-old girl with a history of asthma who presented with an acute exacerbation triggered by a viral infection. She initially responded well to treatment with inhaled Becotide and Ventolin but her condition has now worsened with a persistent cough and peak expiratory flow rate declining to 140 L/min. Due to the severity of her current episode, the referring doctor feels admission is warranted for further observation and treatment.
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Sample Response
Emma Johnson is an 11-year-old girl with a history of asthma who presented with an acute exacerbation triggered by a viral infection. She initially responded well to treatment with inhaled Becotide and Ventolin but her condition has now worsened with a persistent cough and peak expiratory flow rate declining to 140 L/min. Due to the severity of her current episode, the referring doctor feels admission is warranted for further observation and treatment.
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SAMPLE RESPONSE: LETTER OF REFERRAL
10 April2010
Dr B Townsend Emergency Department Newtown Children’s Hospital
Dear Dr Townsend
Re: Emma Johnson
Thank you for assessing this 11-year-old girl with an acute exacerbation of asthma triggered by a viral upper respiratory infection. Apart from a family history of asthma in her mother and 1 5- year-old sister, she has been otherwise well and has no other significant past medical history. She initially presented in November with, a mild episode of asthma related to a similar viral infection. At that time, her PEFR was 250 L/min (expected value 350 L/min). She developed a persistent nocturnal cough which responded partially to a trial of inhaled Ventolin but improved significantly with the introduction of inhaled Becotide 2002 puffs t.d.s. After a four-week trial of Becotide her PEFR was 340 L/min. She ،s currently maintained on this dose of Becotide with additional Ventolin as required. Today she presented with a 45-hour history of upper respiratory symptoms and worsening shortness of breath; on examination she has widespread wheeze and her PEFR is now 140 L/min. She has had one Ventolin nebulizer here at the surgery, with little relief, and I feel that the severity of this episode warrants admission for further observation and treatment.