Emergency Scenario 780_f3

Location Information

Full Location:

Hafnarbraut 2, 780 Höfn í Hornafirði. Single-story building, reinforced concrete construction, built in 1995. Main entrance faces the street, accessible via a single door. No security features. Parking available directly in front of the building. Current conditions: 8°C, overcast, light wind, good visibility. GPS coordinates: 64.2522° N, 15.2056° W. Nearest landmark: Höfn Harbour.

Municipality: Höfn

Postal Code: 780

Emergency Details

Type: Infectious Disease Transfer

Priority Level: F3

Response Time Goal: Standard (30-60 minutes)

Description:

68-year-old female, confirmed case of Clostridium difficile infection requiring transfer from Höfn Health Center to Landspítali National University Hospital in Reykjavík for further management. Patient is stable, afebrile, but has persistent diarrhea and is dehydrated. Patient is alert and oriented. No acute distress. Medical history: Type 2 diabetes, hypertension, recent hospitalization for pneumonia. Medications: Metformin 500mg twice daily, Lisinopril 10mg daily, Vancomycin 125mg four times daily. Known allergy to penicillin. Last meal was a light lunch at 13:00.

History of Events

Timeline:
0700 hours: Patient reports increased frequency of diarrhea
0800 hours: Patient assessed by nurse, started on oral rehydration
0900 hours: Stool sample taken, sent for analysis
1000 hours: Lab confirms C. difficile infection
1100 hours: Physician orders transfer to Landspítali
1130 hours: Current time, patient stable, awaiting transport

Prior Events: Patient was hospitalized for pneumonia 2 weeks ago, received intravenous antibiotics. Discharged 5 days ago. No other recent hospitalizations or significant medical events.

Diagnostics

Initial Assessment

Initial Impression: Confirmed Clostridium difficile Infection requiring transfer
Justification for F3 Classification:
- Patient is stable, no acute life-threatening symptoms
- Transfer is necessary for ongoing management of the infection and potential complications
- Condition is time-sensitive but does not require immediate intervention

Differential Diagnoses:
1. Clostridium difficile infection (confirmed)
2. Dehydration secondary to diarrhea
3. Electrolyte imbalance (likely)
4. Potential complications from recent pneumonia

Required Actions:
- Dispatch of ground ambulance for non-emergency transfer
- Monitoring of patient's hydration status and vital signs during transport
- Continuation of Vancomycin therapy as prescribed
- Transfer to Landspítali for further care

Final Diagnosis

Final Diagnosis: Clostridium difficile Infection with Dehydration
Key Findings:
- Stool culture confirmed C. difficile infection
- Patient showed signs of moderate dehydration
- Electrolyte panel revealed mild hypokalemia
- No other significant medical findings upon arrival at Landspítali

Outcome validated F3 priority assignment. Patient was admitted and received intravenous fluids and electrolyte correction. C. difficile infection was managed with oral Vancomycin. Patient recovered fully within 1 week.

Learning Points:
1. F3 classification was appropriate for a stable patient requiring transfer
2. Initial assessment accurately identified the need for transfer
3. Monitoring of hydration status during transfer was critical

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller This is Guðrún Jónsdóttir calling from the Höfn Health Center. We need to arrange a transfer for a patient with a C. difficile infection.

Dispatcher Okay, can you give me the patient's name and social security number?

Caller Yes, the patient is Helga Ólafsdóttir, kennitala is ******-****.

Dispatcher And what is the patient's current condition?

Caller She's stable, afebrile, but has persistent diarrhea and is dehydrated. We've confirmed C. difficile. She needs to be transferred to Landspítali in Reykjavík.

Dispatcher Is she in any acute distress?

Caller No, she's alert and oriented, not in any acute distress. She is on oral Vancomycin.

Dispatcher Okay, I'm arranging a transfer now. Is there anything else I should know?

Caller She has type 2 diabetes, hypertension and a penicillin allergy. She had pneumonia recently. Her last meal was a light lunch at 13:00.

Dispatcher Alright, thank you for the information. We'll send an ambulance as soon as possible. It's a standard transfer, so expect them within 30 to 60 minutes.

Caller Thank you, we will wait here.