Emergency Scenario 550_f3

Location Information

Full Location:

Hafnarbraut 1, 550 Sauðárkrókur. First floor of a single-story clinic building. Main entrance at the front. No security features. Ample parking. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.7461° N, 19.6417° W. Nearest landmark: Sauðárkrókur Harbour.

Municipality: Sauðárkrókur

Postal Code: 550

Emergency Details

Type: Medical Evaluation Transfer

Priority Level: F3

Response Time Goal: Standard (30-60 minutes)

Description:

72-year-old female, requires transfer for medical evaluation. Primary symptoms: Stable but elevated blood pressure, mild shortness of breath. Patient is alert and oriented. Secondary symptoms: Reports feeling tired, slight chest discomfort. Patient is currently in the local health clinic. Medical history: Hypertension, type 2 diabetes, previous myocardial infarction 5 years ago. Medications: Metformin 1000mg twice daily, Lisinopril 20mg daily, Atorvastatin 20mg daily, Aspirin 75mg daily. Allergies: Sulfa drugs. Last meal was a light lunch at 13:00. Recent healthcare contact: Routine check-up at local clinic today.

History of Events

Timeline:
1000 hours: Patient attended routine check-up at local clinic
1030 hours: Elevated blood pressure detected (170/95)
1100 hours: Patient reports mild shortness of breath and chest discomfort
1130 hours: Clinic staff initiated medical evaluation transfer request
1145 hours: Current time, patient is stable and awaiting transfer

Prior Events: Patient has a history of well-managed hypertension and type 2 diabetes. Previous myocardial infarction 5 years ago, with no subsequent cardiac events. Compliant with medication regimen. No recent changes in health status. Last medical check-up was 3 months ago, routine follow-up.

Diagnostics

Initial Assessment

Initial Impression: Medical Evaluation Transfer for Possible Cardiovascular Instability
Justification for F3 Classification:
- Patient is stable but requires further evaluation due to elevated blood pressure, mild shortness of breath, and chest discomfort
- History of previous myocardial infarction increases risk of cardiovascular event
- Transfer is required for further assessment and possible intervention
- Condition is not immediately life-threatening but requires timely medical attention

Differential Diagnoses:
1. Unstable Angina (possible given history and symptoms)
2. Exacerbation of Hypertension (likely given current BP)
3. Non-Cardiac Chest Pain (less likely given history)
4. Decompensated Heart Failure (less likely given stable condition)

Required Actions:
- Dispatch of BLS ambulance for non-emergent transfer
- Monitoring of vital signs during transport
- Notification of receiving facility with patient's medical history and current status

Final Diagnosis

Final Diagnosis: Hypertension with Mild Angina
Key Findings:
- ECG showed no acute ST-segment changes, but minor T-wave inversions
- Troponin levels were negative, ruling out acute myocardial infarction
- Blood pressure remained elevated despite initial treatment
- Patient reported resolution of chest discomfort after rest and sublingual nitroglycerin

Outcome validated F3 priority assignment. Timely transfer allowed for thorough evaluation and appropriate management. Patient was admitted for observation and adjustment of antihypertensive medications.

Learning Points:
1. F3 classification appropriate for stable patients requiring further evaluation
2. Initial assessment accurately identified the need for medical transfer
3. Prompt transfer and monitoring allowed for timely diagnosis and management of the patient's condition

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller This is Guðrún from the health clinic in Sauðárkrókur. We need a medical transfer for a patient.

Dispatcher Okay, what is the patient's condition and what is the transfer location?

Caller The patient is 72 years old, female. She has elevated blood pressure, mild shortness of breath, and some chest discomfort. We need to transfer her to the hospital in Akureyri.

Dispatcher What is her medical history and medications?

Caller She has hypertension, type 2 diabetes, and a previous heart attack. She takes Metformin, Lisinopril, Atorvastatin, and Aspirin. She is allergic to sulfa drugs.

Dispatcher Is she stable at the moment?

Caller Yes, she is stable but we need her evaluated further. Her blood pressure is 170 over 95.

Dispatcher Okay, I'm dispatching a BLS ambulance for a non-emergent transfer. Please keep monitoring her and be ready for the crew to arrive.

Caller Okay, thank you. We will be ready.