Emergency Scenario 600_f3

Location Information

Full Location:

Hlíðarvegur 14, 600 Akureyri. Single-story residential home, built in 1965, wood frame construction. Main entrance at ground level, no steps. Driveway access. No security features. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6735° N, 18.0867° W. Nearest landmark: Akureyri Hospital.

Municipality: Akureyri

Postal Code: 600

Emergency Details

Type: Medical Evaluation Transfer

Priority Level: F3

Response Time Goal: Standard (30-60 minutes)

Description:

78-year-old male, requires transfer from home to Akureyri Hospital for scheduled evaluation of chronic heart failure. Patient is stable but requires stretcher transport due to limited mobility. Patient is conscious, alert, and oriented. Primary symptoms: Mild shortness of breath on exertion, peripheral edema. Secondary symptoms: Fatigue. Medical history: Chronic heart failure (diagnosed 5 years ago), hypertension, type 2 diabetes. Medications: Furosemide 40mg daily, Metoprolol 50mg twice daily, Metformin 500mg twice daily, Aspirin 75mg daily. Allergies: None known. Last meal: Light lunch at 13:00. Patient is in his living room, seated in a recliner.

History of Events

Timeline:
1400 hours: Patient is stable, as per scheduled transfer request from physician
1405 hours: Patient feels slight increase in shortness of breath, as is usual with activity
1410 hours: Caregiver calls for scheduled transport to hospital.
1415 hours: Current time, patient is awaiting transfer.

Prior Events: Patient has been managing chronic heart failure at home with regular medication and diet. Last hospital admission was 6 months ago for exacerbation of heart failure. Regular check-ups with cardiologist. Patient uses a walker for mobility.

Diagnostics

Initial Assessment

Initial Impression: Scheduled transfer for chronic heart failure evaluation.
Justification for F3 Classification:
- Patient is stable but requires stretcher transport due to limited mobility and pre-existing condition.
- Time-sensitive but not immediately life-threatening condition.
- Transfer is for a scheduled evaluation, not an acute emergency.

Differential Diagnoses:
1. Chronic Heart Failure Exacerbation (low probability, patient stable)
2. Decompensated Heart Failure (unlikely, patient stable)
3. Medication Side Effects (low probability, patient compliant with medication)
4. Routine medical evaluation (high probability)

Required Actions:
- Dispatch of ground EMS with BLS capabilities
- Ensure patient comfort during transport
- Transport to Akureyri Hospital for scheduled evaluation

Final Diagnosis

Final Diagnosis: Stable Chronic Heart Failure for Scheduled Evaluation.
Key Findings:
- Patient's vital signs were stable upon arrival at the hospital.
- Evaluation confirmed no acute exacerbation of heart failure.
- Routine blood work and echocardiogram were completed as planned.

Outcome validated F3 priority assignment. Transport was completed without incident. Patient was admitted for scheduled evaluation and medication adjustment.

Learning Points:
1. F3 classification appropriate due to the non-acute nature of the transfer
2. Initial assessment accurately identified the stability of the patient
3. Pre-arranged transfers can be efficiently managed with F3 protocols

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller This is Jónas Einarsson. I need a transfer to the hospital for my scheduled checkup. My doctor arranged it.

Dispatcher Okay, I see the transfer request. What is your address?

Caller It's Hlíðarvegur 14, in Akureyri.

Dispatcher Help is on its way. Can you tell me about your condition?

Caller I have chronic heart failure. I am a bit short of breath, like always, but I am stable. I just need a ride.

Dispatcher Are you feeling any chest pain?

Caller No, no chest pain. Just the usual shortness of breath and some swelling in my legs.

Dispatcher Okay, the ambulance is on its way. Please stay calm and wait for them.

Caller Thank you. I will wait here.