Emergency Scenario 690_f3

Location Information

Full Location:

Hafnarbraut 12, 690 Vopnafjörður. Single-story wooden house, built in 1965. Main entrance is on the north side, no special security features. Gravel driveway, street parking available. Current conditions: 8°C, overcast, light wind. GPS coordinates: 65.7535° N, 14.8327° W. Nearest landmark: Vopnafjörður harbor.

Municipality: Vopnafjörður

Postal Code: 690

Emergency Details

Type: Medical Evaluation Transfer

Priority Level: F3

Response Time Goal: Standard (30-60 minutes)

Description:

75-year-old female, needs transfer from Vopnafjörður Health Clinic to Akureyri Hospital for further evaluation of chronic kidney disease. Patient is stable, but requires specialized nephrology services not available locally. Patient is alert and oriented. Primary symptoms: General weakness, mild fatigue, slight edema in lower extremities. Secondary symptoms: None reported at this time. Patient is currently in a hospital bed at the clinic. Medical history: Chronic kidney disease (Stage 3), hypertension, type 2 diabetes. Medications: Metformin 500mg twice daily, Lisinopril 10mg daily, Atorvastatin 20mg daily, Sevelamer 800mg three times daily. Known allergies: None. Last meal was a light lunch at 12:00.

History of Events

Timeline:
0800 hours: Patient presented to Vopnafjörður Health Clinic for routine check-up.
0900 hours: Blood tests revealed worsening kidney function.
1000 hours: Physician recommends transfer to Akureyri for specialized nephrology evaluation.
1300 hours: Current time, patient is stable and awaiting transfer.

Prior Events: Patient has been managing chronic kidney disease for 5 years. Regular check-ups and medication adjustments have been ongoing. No recent acute illnesses or changes in medication regimen. Patient lives at home with her husband, who is able to assist with daily activities. Last dialysis was 6 months ago. No recent hospitalizations.

Diagnostics

Initial Assessment

Initial Impression: Chronic Kidney Disease (Stage 3) requiring transfer for further evaluation.
Justification for F3 Classification:
- Patient is stable, not in acute distress, but requires specialized medical care not available locally.
- Transfer is necessary for optimal management of chronic condition.
- Time-sensitive but not life-threatening situation, allowing for a standard response time.

Differential Diagnoses:
1. Exacerbation of Chronic Kidney Disease (most likely)
2. Acute Kidney Injury (less likely given gradual symptom onset)
3. Fluid Overload (possible, but not acutely severe)
4. Electrolyte Imbalance (possible, but not acutely symptomatic)

Required Actions:
- Dispatch of ground ambulance for non-emergency transfer.
- Ensure patient's medications and medical records are transferred with her.
- Notify Akureyri Hospital of patient's arrival for nephrology consultation.

Final Diagnosis

Final Diagnosis: Chronic Kidney Disease (Stage 3) with mild exacerbation.
Key Findings:
- Blood tests at Akureyri Hospital confirmed worsening kidney function but no acute kidney injury.
- Patient's symptoms were consistent with chronic kidney disease and mild fluid overload.
- No other acute medical conditions were identified.

Outcome validated F3 priority assignment. Patient was admitted for observation, medication adjustment, and further evaluation by a nephrologist.

Learning Points:
1. F3 classification appropriate due to the non-acute nature of the transfer.
2. Initial assessment correctly identified the need for specialized care.
3. Transfer was completed without incident, and patient received appropriate care at the receiving facility.

Emergency Call Transcript

Dispatcher Emergency services, this is the dispatch center. What is your emergency?

Caller Good day, this is Hildur Jónsdóttir calling from Vopnafjörður Health Clinic. We need a transfer for a patient to Akureyri Hospital.

Dispatcher Okay, can you provide me with the patient's details and the reason for the transfer?

Caller Yes, the patient is a 75-year-old female with chronic kidney disease. Her name is Guðrún Ólafsdóttir, kennitala ******-****. She needs further evaluation by a nephrologist, which we can't provide here.

Dispatcher Is the patient stable at the moment?

Caller Yes, she is stable. She is alert and oriented, but has some mild weakness and swelling in her legs. She is currently in a hospital bed here at the clinic.

Dispatcher Does she have any other medical conditions or allergies?

Caller Yes, she has hypertension and type 2 diabetes. She takes medications for all of these conditions. No known allergies. Her last meal was a light lunch at 12:00.

Dispatcher Okay, we will arrange a transfer for her. Please make sure her medical records and medications are ready for transport. The ambulance will be there within the standard response time.

Caller Alright, thank you. We will have everything ready. We appreciate your help.