Emergency Scenario 600_f3

Location Information

Full Location:

Hlíðarvegur 17, 600 Akureyri, ground floor apartment 1B. Two-story wooden residential building constructed in 1965. Main entrance is at street level with a single door. No elevator. Limited street parking available. Building is not equipped with a fire alarm system. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6802° N, 18.0845° W. Nearest landmark: Akureyri Botanical Garden.

Municipality: Akureyri

Postal Code: 600

Emergency Details

Type: Medical Evaluation Transfer

Priority Level: F3

Response Time Goal: Standard (30-60 minutes)

Description:

72-year-old male, requires transfer from home to Akureyri Hospital for scheduled follow-up of chronic heart failure. Patient is stable, but needs assistance with ambulation and has oxygen requirement. Primary symptom: Mild shortness of breath on exertion. Secondary symptoms: Mild leg swelling. Patient is alert and cooperative. Medical history: Chronic heart failure (NYHA Class III), hypertension, type 2 diabetes. Medications: Furosemide 40mg daily, Metoprolol 50mg twice daily, Metformin 500mg twice daily, Aspirin 75mg daily. Known allergies: None. Last meal was a light lunch at 12:00.

History of Events

Timeline:
1300 hours: Patient finished lunch, feeling stable.
1315 hours: Patient’s daughter called for transport as pre-arranged for the appointment.
1320 hours: Current time, patient is stable and waiting for transport.

Prior Events: Patient has been managing his heart failure at home with medication and dietary restrictions. He has had multiple hospitalizations for exacerbations in the past, but has been stable for the last 6 months. Last medical check-up was 2 weeks ago with stable condition noted. No recent changes in medications or symptoms other than the usual shortness of breath with exertion. Patient lives with his daughter who is able to provide assistance but cannot transport him.

Diagnostics

Initial Assessment

Initial Impression: Stable Chronic Heart Failure for Scheduled Transfer
Justification for F3 Classification:
- Patient is stable and not in acute distress
- Transfer is for scheduled follow-up, not an emergency
- Patient requires assistance with ambulation and has an oxygen requirement, making a non-emergency transport appropriate

Differential Diagnoses:
1. Stable Chronic Heart Failure (primary concern)
2. Mild Decompensation of Heart Failure (unlikely, patient is stable)
3. Exacerbation of COPD (no history of COPD)
4. Hypoglycemia (unlikely, patient is diabetic but stable)

Required Actions:
- Dispatch of BLS ambulance for scheduled transfer
- Oxygen administration during transport
- Ensure patient's medications and medical records are available for transfer
- Monitor patient's vital signs during transport

Final Diagnosis

Final Diagnosis: Stable Chronic Heart Failure
Key Findings:
- Patient arrived at the hospital in stable condition, no changes from initial assessment.
- Vital signs were within normal limits for the patient’s baseline.
- Patient was able to complete his scheduled appointment without complications.

Outcome validated F3 priority assignment. Transfer was completed without incident.

Learning Points:
1. F3 classification was appropriate for this non-emergency scheduled transfer.
2. Initial assessment accurately reflected the patient's stable condition.
3. Pre-arranged transfers require clear communication and coordination between dispatch, transport, and receiving facility.

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller Good afternoon, I am calling to request transport for my father to Akureyri Hospital for his appointment. It was pre-arranged.

Dispatcher Okay, can you provide me with your address and your father's name and kennitala?

Caller Yes, the address is Hlíðarvegur 17, apartment 1B. My father's name is Jónas Einarsson and his kennitala is ******-****.

Dispatcher Thank you. What is your father's condition? Is he stable?

Caller Yes, he is stable. He has chronic heart failure and requires oxygen. He also needs help walking.

Dispatcher Okay, I understand. He is scheduled for a follow-up appointment at Akureyri Hospital, correct?

Caller Yes, that is correct.

Dispatcher Okay, I will arrange for a non-emergency transport to take him to the hospital. It should be there within the next hour. Please make sure he is ready.

Caller Thank you very much. We will be ready.