Emergency Scenario 700_f3

Location Information

Full Location:

Hótel Hérað, Miðvangi 5-7, 700 Egilsstaðir. Three-story hotel, built in 1950, renovated in 2018. Main entrance facing Miðvangur, additional service entrance on the west side. Elevator and central staircase. Parking lot adjacent to the building. Current conditions: 8°C, overcast, good visibility, light wind. GPS coordinates: 65.2673° N, 14.3939° 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:

72-year-old female, confirmed case of Clostridioides difficile infection (CDI) at Hótel Hérað. Patient requires transfer to the regional hospital in Egilsstaðir for further management. Primary symptoms: Persistent diarrhea (6-8 times per day), mild abdominal cramping, low-grade fever (37.8°C). Patient is stable, alert, and oriented. Medical history: Type 2 diabetes, hypertension. Medications: Metformin 500mg twice daily, Lisinopril 10mg daily. No known allergies. Last meal was a light lunch at 13:00.

History of Events

Timeline:
0800 hours: Patient woke up with increased frequency of bowel movements
1000 hours: Patient reported diarrhea and abdominal cramping to hotel staff
1200 hours: Hotel staff contacted the local health center. CDI suspected
1400 hours: Local health center confirmed CDI via stool sample
1430 hours: Health center requested transfer to regional hospital for further management
1445 hours: Current time, patient is stable, awaiting transport

Prior Events: Patient was admitted to the local health center for 3 days last week for a UTI, received intravenous antibiotics. No recent surgeries or other significant medical events. Last medical check-up 2 months ago for routine follow-up of chronic conditions. Patient is a tourist and staying at the hotel.

Diagnostics

Initial Assessment

Initial Impression: Confirmed Clostridioides difficile Infection (CDI) requiring transfer
Justification for F3 Classification:
- Patient has a confirmed infectious disease requiring further medical management
- Patient is stable with no immediate life-threatening symptoms
- Transfer is time-sensitive but does not require immediate emergency response

Differential Diagnoses:
1. CDI (confirmed)
2. Other infectious causes of diarrhea (less likely given positive CDI test)
3. Exacerbation of underlying conditions (less likely, no other symptoms)

Required Actions:
- Dispatch of BLS ambulance for interfacility transfer
- Ensure appropriate infection control protocols are followed
- Provide supportive care during transport
- Notify receiving hospital of patient transfer

Final Diagnosis

Final Diagnosis: Clostridioides difficile Infection (CDI), uncomplicated
Key Findings:
- Stool culture confirmed C. difficile toxin
- Patient's symptoms consistent with CDI
- No evidence of dehydration or electrolyte imbalance
- No signs of toxic megacolon or other complications

Outcome validated F3 priority assignment. Patient was transferred to the hospital and started on oral vancomycin. Patient responded well to treatment.

Learning Points:
1. F3 classification appropriate due to the non-emergent nature of the transfer
2. Initial assessment accurately identified the need for transfer to higher level of care
3. Emphasis on infection control protocols during transport is critical

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller This is Hjördís from the health center in Egilsstaðir. We need to arrange a non-emergency transfer for a patient at Hótel Hérað.

Dispatcher Okay, what is the patient's condition and why do they need a transfer?

Caller The patient is a 72-year-old female, she has a confirmed C. difficile infection and needs to be transferred to the regional hospital.

Dispatcher Okay, and what are her symptoms?

Caller She has diarrhea, mild abdominal cramping, and a low-grade fever. She is stable.

Dispatcher What is her name and kennitala?

Caller Her name is Hjördís Jónsdóttir, kennitala is ******-****.

Dispatcher Does she have any allergies or medical conditions?

Caller She has type 2 diabetes and hypertension, she takes metformin and lisinopril. No known allergies.

Dispatcher Okay, the ambulance is being dispatched. They will be there within the next hour.

Caller Thank you, we will await their arrival.