Emergency Scenario 700_f3

Location Information

Full Location:

Miðgarður 2, 700 Egilsstaðir, single-story residential home. Built in 1985, wood frame construction. Main entrance is accessible via a small ramp. No security system. Ample street parking. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.2657° N, 14.3944° W. Nearest landmark: Egilsstaðir Swimming Pool.

Municipality: Egilsstaðir

Postal Code: 700

Emergency Details

Type: Medical Evaluation Transfer

Priority Level: F3

Response Time Goal: Standard (30-60 minutes)

Description:

78-year-old female, scheduled transfer for medical evaluation. Primary symptoms: Chronic lower back pain, reports increased discomfort over the past 2 days. Secondary symptoms: Mild fatigue, no fever, normal appetite. Patient is alert, oriented, and ambulatory with slight difficulty. Patient is currently in her home. Medical history: Osteoarthritis, hypertension, Type 2 diabetes. Medications: Metformin 500mg BID, Lisinopril 10mg daily, Paracetamol 500mg PRN. Allergies: None known. Last meal was lunch at 12:00.

History of Events

Timeline:
Two days ago: Patient reported increased lower back pain, rated 5/10
Yesterday: Pain slightly increased, patient took paracetamol
Today: Pain continues, rated 6/10, patient contacted her doctor
14:00: Doctor requested transfer to hospital for further evaluation
14:15: Current time, patient is waiting for transport.

Prior Events: Patient has a long history of osteoarthritis, managed with medication. Recent medical check-up 2 weeks ago, routine follow-up. Patient lives alone, but has family nearby.

Diagnostics

Initial Assessment

Initial Impression: Chronic Lower Back Pain Exacerbation
Justification for F3 Classification:
- Patient's condition is stable, no acute life-threatening symptoms
- Transfer required for further evaluation but not an immediate emergency
- Time-sensitive but not urgent, allowing for standard response time

Differential Diagnoses:
1. Osteoarthritis Exacerbation (most likely)
2. Muscular Strain (possible, but less likely given chronic history)
3. Spinal Stenosis (possible, requires further evaluation)
4. Vertebral Compression Fracture (less likely given no history of trauma)

Required Actions:
- Dispatch of ground EMS for non-emergency transfer
- Ensure patient comfort during transport
- Monitor patient's condition during transfer

Final Diagnosis

Final Diagnosis: Osteoarthritis Exacerbation with Mild Lumbar Spinal Stenosis
Key Findings:
- Physical examination and imaging confirmed osteoarthritis changes in the lumbar spine
- MRI revealed mild spinal stenosis contributing to the patient's symptoms
- No evidence of acute injury or infection

Outcome validated F3 priority assignment. Patient was managed with pain medication and physiotherapy. No urgent intervention was required. 

Learning Points:
1. F3 classification was appropriate for a stable patient requiring transfer for further evaluation
2. Initial assessment accurately identified the chronic nature of the pain
3. The combination of osteoarthritis and mild spinal stenosis explained the patient's symptoms

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller Hello, this is Guðrún Jónsdóttir. My doctor has asked for me to be transferred to the hospital for evaluation of my back pain.

Dispatcher Okay, I understand. What is your address?

Caller It's Miðgarður 2, in Egilsstaðir.

Dispatcher Okay, help is on its way. Can you tell me more about your back pain?

Caller It's been getting worse over the last two days. It's in my lower back. I've had osteoarthritis for years, but this is more painful than usual.

Dispatcher Are you able to walk?

Caller Yes, but it's a little difficult. I am not in immediate danger, my doctor just wants me checked out.

Dispatcher Do you have any other medical conditions?

Caller Yes, I have hypertension and type 2 diabetes. I take medication for both.

Dispatcher Okay, the transport is on its way. Please stay calm and wait for them to arrive.

Caller Okay, thank you. I will wait here.