Hlíðarvegur 14, 600 Akureyri. Ground floor of a two-story residential building built in 1995. Main entrance is accessible via a ramp. No elevator. Street parking available. Building has a basic security system with a key lock. Current weather: 8°C, overcast, light breeze. GPS coordinates: 65.6752° N, 18.0935° W. Nearest landmark: Akureyri Hospital.
72-year-old male, scheduled for transfer from home to Akureyri Hospital for further evaluation of chronic kidney disease and recent worsening of symptoms. Primary symptoms: Generalized weakness, fatigue, mild shortness of breath on exertion, and peripheral edema. Patient is alert, oriented, and cooperative. Patient is in a wheelchair. Medical history: Chronic kidney disease stage 4, hypertension, type 2 diabetes, previous myocardial infarction 5 years ago. Medications: Metformin 500mg twice daily, Lisinopril 10mg daily, Atorvastatin 20mg daily, Furosemide 40mg daily. Allergies: No known allergies. Last meal was a light lunch at 12:00.
Timeline: 1300 hours: Patient finished lunch 1315 hours: Patient reported feeling more fatigued than usual 1330 hours: Patient's daughter called primary care physician, who recommended transfer to hospital 1345 hours: Primary care physician contacted emergency services to arrange transport 1400 hours: Current time, patient is stable and awaiting transfer. Prior Events: Patient has been managing chronic kidney disease at home. Recent lab results show declining kidney function. Patient has had increasing fatigue and swelling in the legs over the past two weeks. Patient has been compliant with medications. No recent infections or other significant medical events.
Initial Impression: Medical Transfer for Chronic Kidney Disease Exacerbation Justification for F3 Classification: - Patient is stable but requires further evaluation and management of chronic kidney disease - No immediate life threats, but condition warrants timely hospital transfer - Symptoms indicate potential worsening of renal function, requiring assessment and possible intervention Differential Diagnoses: 1. Chronic Kidney Disease Exacerbation (most likely) 2. Congestive Heart Failure Exacerbation (possible given history) 3. Electrolyte Imbalance (possible secondary to kidney disease) 4. Anemia (possible secondary to kidney disease) Required Actions: - Dispatch of ground EMS for routine medical transfer - Ensure patient comfort during transport - Monitor vital signs during transport - Transfer to Akureyri Hospital for nephrology evaluation