Emergency Scenario 400_f3

Location Information

Full Location:

Hlíðarvegur 10, 400 Ísafjörður, ground floor apartment. A two-story wooden residential building constructed in 1965. Main entrance is accessible via a ramp. No elevator. Parking available on street. Building has a basic fire alarm system. Current conditions: 3°C, overcast, moderate visibility. GPS coordinates: 66.0745° N, 23.1243° W. Nearest landmark: Ísafjörður Hospital.

Municipality: Ísafjörður

Postal Code: 400

Emergency Details

Type: Infectious Disease Transfer

Priority Level: F3

Response Time Goal: Standard (30-60 minutes)

Description:

78-year-old female, confirmed case of Clostridium difficile infection, requires transfer from home to Ísafjörður Hospital for further management. Patient stable but requires isolation. Primary symptoms: Persistent diarrhea (10-12 times per day), mild abdominal cramping, low-grade fever (37.8°C). Secondary symptoms: Fatigue, dehydration. Patient alert and oriented. Patient is currently in her bedroom. Medical history: Recent hospitalization for pneumonia, completed antibiotic course (Clindamycin). Medications: Probiotics, oral rehydration solution. No known allergies. Last meal was a light soup at 18:00.

History of Events

Timeline:
1000 hours: Patient developed watery diarrhea, initially mild
1200 hours: Diarrhea increased in frequency and severity, mild abdominal cramps started
1400 hours: Patient contacted her primary care physician, who suspected C. difficile
1600 hours: C. difficile test confirmed positive at Ísafjörður Health Center
1800 hours: Patient has had 10-12 episodes of diarrhea, mild fever (37.8°C), fatigue
1900 hours: Current time, transfer to hospital requested

Prior Events: Patient was hospitalized for pneumonia 2 weeks ago and treated with intravenous Clindamycin. Discharged 1 week ago. No recent travel history. Patient lives alone, but receives daily visits from her daughter.

Diagnostics

Initial Assessment

Initial Impression: Suspected Clostridium difficile Infection Requiring Transfer
Justification for F3 Classification:
- Confirmed C. difficile infection requires hospital management for isolation and further treatment
- Patient is stable but symptomatic with dehydration concerns
- Time-sensitive for infection control but not life-threatening

Differential Diagnoses:
1. Clostridium difficile Infection (Confirmed)
2. Other infectious causes of diarrhea (less likely due to recent antibiotic use)
3. Medication-induced diarrhea (less likely given the positive C. difficile test)

Required Actions:
- Dispatch of standard transport EMS with appropriate isolation precautions
- Ensure patient comfort and hydration during transport
- Notification to hospital for infection control preparations
- Monitoring of vital signs during transport

Final Diagnosis

Final Diagnosis: Clostridium difficile Infection
Key Findings:
- Patient’s symptoms consistent with C. difficile infection
- Positive C. difficile test confirmed the diagnosis
- Dehydration was mild; patient responded well to oral rehydration
- No other complications or co-infections were identified

Outcome validated F3 priority assignment. Transfer was performed safely and efficiently. Patient was admitted to isolation ward and started on appropriate treatment.

Learning Points:
1. F3 classification appropriate for stable infectious disease transfers
2. Accurate initial assessment of infection risk and stability
3. Prompt transfer facilitated appropriate isolation and treatment

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller Hello, this is Guðrún Jónsdóttir. My mother needs to be transferred to the hospital. She has a C. difficile infection.

Dispatcher Okay, I understand. What is your mother's address?

Caller It's Hlíðarvegur 10 in Ísafjörður, ground floor apartment.

Dispatcher And what is your mother's name and kennitala?

Caller Her name is Guðrún Jónsdóttir, kennitala is ******-****.

Dispatcher Okay, and can you tell me more about her condition?

Caller She has been having severe diarrhea all day, maybe 10-12 times. She has a little fever and is tired.

Dispatcher Has she been seen by a doctor?

Caller Yes, she was tested at the health center and it came back positive for C. difficile. They said she needs to go to the hospital.

Dispatcher Okay, an ambulance is being dispatched for a non-emergency transfer. Please ensure she has her medications and any personal items she needs.

Caller Yes, I have them ready. Thank you for your help.

Dispatcher You're welcome. They will be there within the hour. Please stay with her until they arrive.