The task
Assume that today's date is 23 October 2026. You received the principal's letter on 19 October 2026.
You are a pharmacist at the community pharmacy where Huong Huynh's medicines are dispensed. Using the information in the case notes, write a letter to Mr Prakash Raghavan, the principal of Huong's primary school, replying to his request for advice on how staff should store and use Huong's adrenaline autoinjector. Address the letter to Mr Prakash Raghavan, Principal, Primary School Office, 45 Railway Parade. In your answer: expand the relevant notes into complete sentences; do not use note form; use letter format. The body of the letter should be approximately 180–200 words.
Length: the body of the letter should be about 180–200 words. You have 45 minutes in the test: 5 minutes to read, 40 to write. Letter type: Response letter.
Case notes
Patient details
- Name: Huong Huynh
- DOB: 14/03/2019 (7 yrs); Year 2 student
- Mother gave verbal + written consent 20/10/26 for pharmacist to share info with school
- Regular pharmacy customer since 2020
Request from school
- Letter from Mr Prakash Raghavan, Principal, rec'd 19/10/26
- Asks: where/how to store device, when to use it, how to use it
- Huong started at school this term; staff not yet trained on her device
Medical history
- Peanut allergy dx age 2 by allergist; anaphylaxis after peanut butter 2021 → ED, discharged next day
- Mild asthma — salbutamol inhaler via spacer PRN
- Eczema in infancy, resolved
- Allergist review 09/26: device strength appropriate for current weight; next review 12/12
- ASCIA Action Plan for Anaphylaxis completed by allergist 09/26; copy given to school by mother
Dispensing record
- EpiPen adrenaline autoinjector x2 dispensed 02/10/26: 1 for school, 1 with family; expiry 08/2027
- Non-sedating antihistamine oral liquid PRN for mild–moderate reactions, as per Action Plan
- Salbutamol inhaler + spacer: 1 kept at school
Counselling points for school
- Store at room temp, below 25°C; do not refrigerate; avoid heat/direct sunlight (e.g. not in car or on windowsill)
- Keep with Action Plan in labelled, unlocked, easily accessible place known to all staff; never locked away
- Device must go with Huong on excursions, sport, camps
- Check monthly: expiry date + viewing window — solution should be clear; if cloudy/discoloured or expired → ask mother for replacement
- Mild–mod reaction (swelling lips/face/eyes, hives/welts, tingling mouth, abdo pain, vomiting): stay with child, follow Action Plan, contact mother, watch for anaphylaxis
- Anaphylaxis signs: difficult/noisy breathing, swollen tongue, swelling/tightness throat, wheeze or persistent cough, difficulty talking/hoarse voice, persistent dizziness or collapse, pale + floppy
- Any anaphylaxis sign → give autoinjector immediately; if in doubt, give adrenaline
- How: lay child flat; if breathing difficult → sit with legs outstretched; if unconscious but breathing normally → recovery position; never let her stand/walk. Hold leg still; pull off blue safety release; place orange end against outer mid-thigh (through clothing OK); push down hard until click; hold 3 sec; remove
- Then call ambulance (000) straight away; note time given; phone mother; further adrenaline may be given if no response after 5 min, if another autoinjector available
- If unsure whether asthma or anaphylaxis: give adrenaline first, then asthma reliever
- Used device → hand to paramedics; replacement needed
Social background
- Lives with mother + grandmother; father working overseas
- Older brother (10 yrs) has hay fever
- Enjoys swimming lessons and drawing
- Mother complained about 20-min wait at pharmacy on 02/10
- Mother said class teacher is 'careless' and 'can't be trusted with Huong'
Plan
- Recommend all staff complete free ASCIA online anaphylaxis training + practise with trainer device (no needle)
- Pharmacist happy to visit school to demonstrate device — on request
Who is reading, and what do they need?
Mr Raghavan is a school principal, not a clinician. Staff have not been trained on Huong's device, and he asked where to store it, when to use it and how. He needs clear, non-technical, ordered instructions that staff could follow, with no unnecessary medical history.
What to include
Selection is the skill the Content and Conciseness criteria reward. These notes earn their place:
| Case note | Why it belongs |
|---|---|
| Mother gave consent 20/10/26 to share information with school | Authorises what the pharmacist may disclose and keeps the reply limited to what the school needs. |
| Principal asked where/how to store, when to use, how to use | The reply should follow his three questions so it clearly answers the request received on 19/10. |
| Room temperature below 25°C, no fridge, avoid heat and direct sunlight | Storage conditions he asked about; the car and windowsill examples make it practical. |
| Labelled, unlocked, accessible place with Action Plan; goes on excursions, sport, camps | Access is critical in an emergency, so staff must know the location and that the device travels with her. |
| Monthly check of expiry date and viewing window | Gives staff a routine to confirm the device is usable, with replacement through her mother if expired, cloudy or discoloured. |
| Full list of anaphylaxis signs; give immediately, if in doubt give adrenaline | Answers 'when to use it'; the list should stay complete and be distinguished from mild–moderate reactions. |
| Lay flat, remove blue safety release, orange end to outer thigh, click, hold 3 seconds | Answers 'how'; includes positioning, never standing her, then 000, noting the time, phoning mother and handing the used device to paramedics. |
| ASCIA online training; pharmacist can visit to demonstrate on request | Staff are untrained, so a training recommendation and offer of support is the practical next step. |
What to leave out or compress
| Case note | Why it goes |
|---|---|
| Mother said class teacher is 'careless' and 'can't be trusted' | Unverified criticism of a named staff member; repeating it would be unprofessional and could harm relationships. |
| Mother complained about a 20-minute wait on 02/10 | Service complaint unrelated to the principal's question. |
| Lives with mother and grandmother; father overseas; brother has hay fever | Family detail irrelevant to school staff and beyond the consent's purpose. |
| Eczema in infancy (resolved); swimming and drawing | Resolved or unrelated, with no bearing on the device. |
| 2021 ED attendance after peanut butter, discharged next day | Detail the school does not need; diagnosis of peanut allergy and the plan are enough. |
| Expiry 08/2027 and allergist review next 12/12 | Trap: looks useful, but staff only need the monthly check routine, not these dates. |
A paragraph plan for this case
Open by acknowledging his letter and the consent, then cover storage and access. Move to recognising reactions, then the steps for giving the autoinjector and what follows. Close with the training recommendation and the offer of a pharmacist visit.
Where candidates slip on this task
- The principal's letter arrived 19 October and the reply is dated 23 October; keep references to consent (20/10) and the Action Plan accurate and do not mention anything the notes do not support.
- Within roughly 200 words you must prioritise, but never shorten the anaphylaxis signs or the order of steps in a way that drops items; compress other counselling points instead.
- Keep the emergency sequence unambiguous: give adrenaline first if unsure whether it is asthma or anaphylaxis, call 000, and give a further dose after 5 minutes only if no response and another autoinjector is available.
No model letter is published here. Write for the named reader from the case notes in the timed editor, then get it marked.
Write it in the timed editor and get marked on the 6 criteria
More Pharmacy letter tasks
- Nurse manager asking about crushing medicines for a resident response letter
- Poor preventer adherence in an asthmatic patient update letter
- Frequent NSAID purchases in a patient with kidney disease update letter
Your profession's guide: OET Pharmacy. Layout and structure: OET letter format.
Questions about this task
How do I fit all the counselling points into the word limit?
Use plain, compact wording and group points under storage, recognising reactions and giving the device. Keep the complete list of anaphylaxis signs and steps; compress mild–moderate reaction detail and leave out the background history.
Should the teacher comment be mentioned?
No. It is the mother's unverified opinion about a named person, it is not clinical information and it is not needed to answer the principal's questions. Mentioning it would be unprofessional.
Sources
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