Emergency Scenario 465_f3

Location Information

Full Location:

Hafnargata 1, 465 Bíldudalur, Single-story wooden structure, built in 1955. Main entrance faces the harbor, with a small ramp. No security features, open access. Weather: 8°C, overcast, light rain, moderate visibility. GPS: 65.7321° N, 23.5834° W. Nearest landmark: Bíldudalur Harbor.

Municipality: Bíldudalur

Postal Code: 465

Emergency Details

Type: Infectious Disease Transfer

Priority Level: F3

Response Time Goal: Standard (30-60 minutes)

Description:

68-year-old female, confirmed case of Clostridium difficile infection, requiring transfer from Bíldudalur Health Clinic to Ísafjörður Hospital for further management. Patient stable, afebrile, but experiencing persistent diarrhea and dehydration. Patient has IV line in situ, with ongoing saline infusion.

History of Events

Timeline:
0800 hours: Patient reported increased frequency of diarrhea, 6 episodes overnight
0900 hours: Patient seen at Bíldudalur Health Clinic, initial assessment and testing performed
1000 hours: C. difficile test positive, treatment initiated with oral vancomycin
1100 hours: Patient's condition remains stable but transfer to Ísafjörður Hospital deemed necessary for more comprehensive care
1130 hours: Current time, transfer requested

Prior Events: Patient admitted to Bíldudalur Health Clinic 3 days prior for a UTI, treated with IV antibiotics. No recent surgeries or other significant medical events. Patient has a history of hypertension, managed with oral medication. Last meal was breakfast at 0700.

Diagnostics

Initial Assessment

Initial Impression: Confirmed Clostridium difficile infection, requiring inter-facility transfer.
Justification for F3 Classification:
- Patient stable, not acutely deteriorating but requires specialized care not available at current facility.
- Time-sensitive transfer due to infection management and potential complications.
- No immediate life threat but requires timely intervention.

Differential Diagnoses:
1. Clostridium difficile infection (confirmed)
2. Dehydration secondary to diarrhea (confirmed)
3. Electrolyte imbalance (possible, pending lab results)
4. Underlying infection from previous UTI (unlikely given C. difficile confirmation)

Required Actions:
- Arrange ground transport with appropriate infection control protocols.
- Transfer with medical staff capable of monitoring and maintaining IV infusion.
- Ensure timely transport to Ísafjörður Hospital for further management.

Final Diagnosis

Final Diagnosis: Confirmed Clostridium difficile infection with associated dehydration and mild hypokalemia.
Key Findings:
- Lab results confirmed C. difficile infection and mild hypokalemia.
- Patient's vital signs remained stable throughout the transfer process.
- IV saline infusion was maintained, and patient's hydration improved during transport.

Outcome validated F3 priority assignment. Transfer was completed without complications. Patient received additional treatment at Ísafjörður Hospital, including electrolyte replacement and continued antibiotic therapy.

Learning Points:
1. F3 classification was appropriate given the need for specialized care and the stable condition of the patient.
2. Early identification of C. difficile infection and timely transfer contributed to optimal patient outcome.
3. Communication between referring and receiving facilities was essential for a smooth transfer.

Emergency Call Transcript

Dispatcher Emergency services, what is the nature of your call?

Caller This is Guðrún Jónsdóttir from Bíldudalur Health Clinic. We need to arrange a patient transfer to Ísafjörður Hospital.

Dispatcher Okay, can you provide me with the patient's details and the reason for the transfer?

Caller Yes, the patient is a 68-year-old female, kennitala ******-****. She has a confirmed case of Clostridium difficile infection and requires further management at the hospital.

Dispatcher Is the patient stable at this time?

Caller Yes, she is stable, afebrile, but has had persistent diarrhea and is receiving IV fluids. She is not in acute distress.

Dispatcher Okay, do you have an IV line in place?

Caller Yes, she has an IV line with saline running.

Dispatcher Understood. I will arrange a transfer. What is your current location?

Caller We are at Bíldudalur Health Clinic, Hafnargata 1, 465 Bíldudalur.

Dispatcher Okay, a transport team will be dispatched shortly. Please ensure you have all necessary paperwork ready for the transfer.

Caller Understood, thank you.