Emergency Scenario 465_f3

Location Information

Full Location:

Hafnargata 23, 465 Bíldudalur, single-story wooden house built in 1955. Main entrance faces the street, no steps. No security features. Current conditions: 8°C, overcast, moderate visibility, light wind. GPS coordinates: 65.6834° N, 23.5347° W. Nearest landmark: Bíldudalur Harbor.

Municipality: Bíldudalur

Postal Code: 465

Emergency Details

Type: Medical Evaluation Transfer

Priority Level: F3

Response Time Goal: Standard (30-60 minutes)

Description:

72-year-old male, needs transfer from home to health center. Primary symptoms: Generalized weakness, fatigue, and mild shortness of breath. Patient is stable but requires medical evaluation for possible fluid overload. Patient is alert and oriented. No acute distress. Medical history: Congestive heart failure, hypertension, type 2 diabetes. Medications: Furosemide 40mg daily, Lisinopril 10mg daily, Metformin 500mg twice daily, Aspirin 81mg daily. Allergies: None known. Last meal was a light lunch at 13:00. Patient is sitting in a chair in the living room.

History of Events

Timeline:
0700 hours: Patient woke up feeling more tired than usual.
1000 hours: Patient noted increased shortness of breath with minimal exertion.
1200 hours: Patient contacted his son for assistance.
1300 hours: Patient had a light lunch.
1400 hours: Son called emergency services for a non-emergency transfer.

Prior Events: Patient has been managing his chronic conditions at home with regular follow-ups. No recent hospitalizations. Last medical check-up was 2 weeks ago. Patient lives alone but receives regular visits from his son.

Diagnostics

Initial Assessment

Initial Impression: Possible Fluid Overload Secondary to Congestive Heart Failure.
Justification for F3 Classification:
- Patient is stable but requires medical evaluation for worsening symptoms.
- No acute life-threatening condition, but symptoms warrant further assessment.
- Standard response time is appropriate.

Differential Diagnoses:
1. Fluid Overload due to CHF (most likely)
2. Medication Side Effects (possible)
3. Exacerbation of COPD (less likely, no history of COPD)
4. Infection (less likely, no fever or productive cough)

Required Actions:
- Dispatch of BLS ambulance for transfer to local health center.
- Basic monitoring of vital signs during transport.
- Report to receiving facility with patient's history and current symptoms.

Final Diagnosis

Final Diagnosis: Exacerbation of Congestive Heart Failure with Mild Fluid Overload.
Key Findings:
- Physical exam at health center showed mild peripheral edema and increased lung sounds.
- Chest X-ray confirmed mild pulmonary congestion.
- ECG showed no acute changes.
- Blood tests showed slightly elevated BNP levels.

Outcome validated F3 priority assignment. Transfer was necessary for further evaluation and management. Patient was treated with increased diuretics and monitored closely. He was discharged home after 3 days with adjusted medications and follow-up instructions.

Learning Points:
1. F3 classification was appropriate given the patient's stable but symptomatic condition.
2. Initial assessment accurately identified fluid overload as the primary concern.
3. Prompt transfer to health center allowed for timely diagnosis and treatment.

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller Hello, my father needs to be transferred to the health center. He's not feeling well.

Dispatcher Okay, what is your father's name and address?

Caller His name is Jón Einarsson, and he's at Hafnargata 23 in Bíldudalur.

Dispatcher And what seems to be the problem?

Caller He's very weak and tired, and he says he's having a little trouble breathing. He has heart problems.

Dispatcher Is he alert and talking to you now?

Caller Yes, he's awake and talking, but he's very weak. He's just sitting in his chair.

Dispatcher Does he have any other medical conditions or allergies?

Caller He has congestive heart failure, high blood pressure, and diabetes. No known allergies.

Dispatcher Okay, we will arrange for a transfer to the health center. Please stay with him and keep him comfortable.

Caller Okay, thank you. I will wait here with him.