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It concerns Ms. Sally McConville, a 38-year-old administrator, who is being referred due to symptoms suggestive of acute asthma or possible pneumonia. The letter details her medical history, including asthma, and describes her recent symptoms, which began on 10/09/2014 with a productive cough, fever, wheezes, and a runny nose. She was initially treated with Ventolin. Two days later, her condition worsened with increased shortness of breath, wheezes, fever, and yellow sputum. She was then prescribed Amoxicillin and prednisolone. Today, she presented with worsening shortness of breath at rest, increased work of breathing, accessory muscle use, widespread wheezes, bibasal crepitations, elevated respiratory rate and pulse rate, and low blood pressure, despite ongoing medication. Salbutamol was administered with no improvement, and she remains in respiratory distress. The referring doctor requests urgent management and investigations, and provides contact information for any queries. 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