QQ.MM.0001. Mr William McGuire – Deteriorated Respiratory Function – Preeti Sehrawat
Electronic Version

Dr. Mandy sutton
Respiratory physician
Department of Respiratory medicine
Central hospital
Bay city

06/october/ 2018

Re:- Mr William Mc Guire, DOB:- 23/05/1953

Dear:- Mr. sutton

Mr. Mc guire is a 65years old retired svhool teacher. who has been presented with the compaint of decrease respiratory function. He needs not only assessment but advice also on management of his condition at your facility..

Mr. Mc guire was diagnosed with COPD since 2016 due to four month history of chronic cough and increase dyspnea . He was hospitalised two times of exacerbation in 2017 and 2018. During the last admission his FEVI decreased to 66% and a week course of pulmonary rehabilitation was arranged.

Today, He return back to hospital with the compaint of slowly increasing dyspnea since last hospitalised and difficulty in breathing at night when who is lying down. on examination, his BP was slightly elevated, chest hyperinflation was noted and according to investigation his expiratory flow rate is 320, FEVI was 42% and other investigations (Ecg, tropnin, Fbc and chest xray) were normal .

As additional information, his curr medications include ventolin, serctide and spiriva. Mr. Mc guire had smoked 40 cigarettes per day for 40 years but since 2013 he stopped smoking. He has a family history of lung disorder (mild COPD and bronchoedasis in his his sister).

I would appreciate it, If you could provide specialist advice regarding possible treatment and home care therapy. I attached all the relevant information regarding Mr. Mc guire with his home address. If you have any quaries please do not hesitate to contact me.

yours sincerely

Doctor

QQ.NN.WW.0002. Ms Nicola Boyle - Emergency Caesarean Section - Tasneem Yousaf

The Director
Community Child Health Service
West End
Brisban 4101

10 January 2018

Re: Ms Nicola Boyle, DOB 8 August 1998

MS Boyle, who has undergone emergency caesarean section, due to fetal distress outcome baby boy weight 4.3kg, is being referred to you to provide home visits and requires support for her and baby. Following the discharge back home today.

She is a single mother and has been no contact to the father of the child. She has been arrived in London for work purpose alone. Since 2015 and has not been in touch with her family. She has been living in a flat with sharing of one female. Presently she has been getting advantage from the government.

Ms Boyle has been leads a healthy life. Decade ago Appendectomy had been done. Primigravida and Prenatal checkup had been started at 14 weeks of gestation without any issues.

On arrival at the hospital presented with the complaint of labour pains. Due to prolong labour fetal distress occurred and caesarean section has been done. Resuscitation has been given to child only for 2 minutes because of low APGAR score at 1 minute.

During her operation postpartum haemorrhage of 800 millilitres blood loss has been notified. During postnatal period she has been discharged on orally Iron medicines and vitamin c complex. She is not sure of caring the baby regarding breast feeding and bathing.

It would be greatly appreciated if you would provide necessity to her and baby. In case of any other information is deemed extremely relevant.do not hesitate to contact me.

Yours faithfully,


Registered Nurse
Maternity Ward
St Michael’s Hospital
South Wales