Emergency Scenario 700_f3

Location Information

Full Location:

Héraðssjúkrahúsið í Austurlandi, Tjarnarbraut 2, 700 Egilsstaðir, Ward 3, Room 305. Single-story hospital building with multiple wings, built in 1970s, renovated in 2010. Main entrance with automatic doors, designated ambulance bay. Limited parking, access code not required. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.2655° N, 14.3948° W. Nearest landmark: Egilsstaðir Airport.

Municipality: Egilsstaðir

Postal Code: 700

Emergency Details

Type: Infectious Disease Transfer

Priority Level: F3

Response Time Goal: Standard (30-60 minutes)

Description:

65-year-old female, confirmed case of Clostridium difficile infection, requires transfer from Héraðssjúkrahúsið í Austurlandi to Landspítali in Reykjavik for specialized care. Patient is stable but requires isolation precautions. Primary symptoms: Persistent diarrhea, dehydration, mild abdominal pain. Secondary symptoms: Low-grade fever (37.8°C), fatigue. Patient alert and oriented. Patient is currently in a single room on Ward 3.

History of Events

Timeline:
0700 hours: Patient started experiencing increased diarrhea frequency.
0900 hours: Patient developed mild abdominal cramping and low-grade fever.
1200 hours: Patient was admitted to Héraðssjúkrahúsið í Austurlandi.
1400 hours: C. difficile infection confirmed via stool sample.
1500 hours: Patient condition stable, decision made to transfer to Landspítali.
1530 hours: Current time, awaiting ambulance for transfer.

Prior Events: Patient was hospitalized for a urinary tract infection 2 weeks ago, treated with broad-spectrum antibiotics. No known allergies. Medications: Vancomycin 125mg QID, Metronidazole 500mg TID, IV fluids (Normal Saline at 100 ml/hr). Past medical history: Type 2 Diabetes, Hypertension. Last oral intake was clear liquids at 1400 hours.

Diagnostics

Initial Assessment

Initial Impression: Confirmed Clostridium difficile Infection requiring transfer.
Justification for F3 Classification:
- Patient is stable but requires transfer for specialized care and isolation.
- Condition is not immediately life-threatening, but requires timely transfer to prevent complications.
- Transfer is routine and can be completed within a standard response time.

Differential Diagnoses:
1. C. difficile infection (confirmed)
2. Other infectious causes of diarrhea (ruled out by stool sample)
3. Medication-related diarrhea (less likely due to confirmed infection)

Required Actions:
- Dispatch of ambulance with infection control protocols.
- Secure patient for transport with necessary isolation measures.
- Ensure patient has IV access and fluids are running.
- Coordinate transfer with receiving hospital at Landspítali.

Final Diagnosis

Final Diagnosis: Confirmed Clostridium difficile Infection requiring transfer to Landspítali.
Key Findings:
- Stool sample confirmed presence of C. difficile toxins.
- Patient's vital signs remained stable throughout the day.
- Patient's condition did not deteriorate during the waiting period.

Outcome validated F3 priority assignment. Patient was successfully transferred to Landspítali without complications.

Learning Points:
1. F3 classification was appropriate given the stable condition and need for transfer.
2. Initial diagnosis was confirmed by lab results.
3. Proper infection control measures are essential during transport of infectious patients.

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller This is Guðrún Jónsdóttir calling from Héraðssjúkrahúsið in Egilsstaðir. We need an ambulance for a patient transfer.

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

Caller Yes, the patient is a 65-year-old female, Guðrún Einarsdóttir, kennitala ******-****. She has a confirmed C. difficile infection and needs to be transferred to Landspítali in Reykjavik for specialized care.

Dispatcher Is the patient stable?

Caller Yes, she is stable. She has persistent diarrhea, mild abdominal pain, and a low-grade fever. She is alert and oriented. She's on Vancomycin and Metronidazole.

Dispatcher Is she on IV fluids?

Caller Yes, she is. Normal saline at 100 ml per hour. She is in room 305 on ward 3.

Dispatcher Okay, I'm dispatching an ambulance. It will be a standard response time. Please ensure all transfer paperwork is ready and the patient is prepared for transport with appropriate isolation precautions.

Caller Understood, we will have everything ready. Thank you.