Emergency Scenario 550_f3

Location Information

Full Location:

Hofsósvegur 7, 550 Sauðárkrókur. Single-story wooden residential house built in 1985. Main entrance via front door, no steps. No security features. Gravel driveway. Current conditions: 8°C, overcast, light wind. GPS coordinates: 65.7500° N, 19.6333° W. Nearest landmark: Sauðárkrókur swimming pool.

Municipality: Sauðárkrókur

Postal Code: 550

Emergency Details

Type: Infectious Disease Transfer

Priority Level: F3

Response Time Goal: Standard (30-60 minutes)

Description:

72-year-old female, confirmed case of influenza A, requiring transfer from home to the health center for isolation and further management. Patient presents with fever, cough, and shortness of breath. Patient is stable but requires oxygen therapy. Patient is ambulatory with assistance. Medical history: Type 2 diabetes, hypertension, chronic bronchitis. Medications: Metformin 500mg twice daily, Lisinopril 10mg daily, Salbutamol inhaler as needed. Allergies: Penicillin. Last meal was a light soup at 12:00. Patient is weak and fatigued.

History of Events

Timeline:
0800 hours: Patient woke up feeling unwell with fever and cough.
1000 hours: Symptoms worsened, including shortness of breath.
1100 hours: Patient's daughter contacted the local health center. Influenza A confirmed via home test.
1300 hours: Current time, health center has requested transfer for isolation and further management. Patient is stable, receiving 2L oxygen via nasal cannula.

Prior Events: Patient reports feeling unwell for the past 3 days, initially thought it was a common cold. No recent hospitalizations. Last medical check-up 6 months ago, routine follow-up. Patient lives with her husband, who is also showing mild symptoms but is not requiring transfer.

Diagnostics

Initial Assessment

Initial Impression: Confirmed Influenza A infection requiring transfer for isolation.
Justification for F3 Classification:
- Patient has a confirmed infectious disease requiring isolation, not immediately life-threatening.
- Patient is stable but requires oxygen therapy, indicating a moderate level of respiratory distress.
- Transfer is time-sensitive to prevent further spread but does not require immediate action.

Differential Diagnoses:
1. Influenza A infection (confirmed)
2. Exacerbation of Chronic Bronchitis (likely contributing to symptoms)
3. Community-Acquired Pneumonia (possible but less likely given confirmed influenza)
4. Decompensated Diabetes (possible but not primary concern)

Required Actions:
- Dispatch of BLS ambulance for non-emergency transfer.
- Oxygen therapy to be continued during transport.
- Appropriate infection control measures to be followed.
- Transfer to the local health center for isolation and further management.

Final Diagnosis

Final Diagnosis: Influenza A infection with exacerbation of chronic bronchitis.
Key Findings:
- Patient's oxygen saturation was 92% on 2L nasal cannula, indicating mild hypoxemia.
- Chest auscultation revealed wheezing and rhonchi, consistent with bronchitis.
- Blood glucose was slightly elevated at 180 mg/dL, likely due to infection.
- Patient's condition remained stable during transfer. No signs of severe respiratory distress or sepsis.

Outcome validated F3 priority assignment. The patient was transferred safely to the health center for isolation and treatment.

Learning Points:
1. F3 classification was appropriate for a stable patient requiring transfer for infection control.
2. Initial assessment accurately identified the need for oxygen therapy and infection control measures.
3. Detailed history helped to differentiate between influenza and other respiratory conditions.

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller Hello, this is Guðrún Jónsdóttir. My mother needs to be transferred to the health center. She has influenza A.

Dispatcher Okay, I'm sending a transfer ambulance. What is your address?

Caller It's Hofsósvegur 7 in Sauðárkrókur.

Dispatcher Help is on its way. Can you tell me what happened?

Caller She has had a fever and cough for three days. It got worse today and she is short of breath. The health center wants her transferred for isolation.

Dispatcher Is she awake and talking to you?

Caller Yes, she's awake but very tired. She is using oxygen at home, 2 liters.

Dispatcher Does she have any medical conditions?

Caller Yes, she has type 2 diabetes, high blood pressure, and chronic bronchitis. She is allergic to penicillin.

Dispatcher Okay, the ambulance is on its way. Do not remove the oxygen and please have her medical records ready for the crew.

Caller Okay, thank you. We will wait here.