Emergency Scenario 780_f3

Location Information

Full Location:

Hafnarbraut 2, 780 Höfn, ground floor, single-story building. Concrete construction, built in 1995. Main entrance is accessible via a ramp. No security features. Current conditions: 8°C, clear skies, good visibility. GPS coordinates: 64.2500° N, 15.2000° W. Nearest landmark: Höfn harbor.

Municipality: Höfn

Postal Code: 780

Emergency Details

Type: Medical Evaluation Transfer

Priority Level: F3

Response Time Goal: Standard (30-60 minutes)

Description:

76-year-old female, scheduled transfer for medical evaluation. Patient is stable but requires transfer to hospital in Egilsstaðir for further assessment of chronic kidney disease. Patient is alert, oriented, and able to communicate. Primary symptoms: General fatigue, decreased appetite. Secondary symptoms: None reported. Patient is currently in her room at the local nursing home. Medical history: Chronic kidney disease stage 3, hypertension, type 2 diabetes. Medications: Metformin 500mg twice daily, Lisinopril 10mg daily, Atorvastatin 20mg daily. Allergies: None known. Last meal was a light dinner at 18:00.

History of Events

Timeline:
0700 hours: Patient woke up, reported general fatigue
0800 hours: Patient had light breakfast, appetite was reduced
1000 hours: Patient's nurse contacted the on-call physician
1100 hours: On-call physician requested transfer for further evaluation
1115 hours: Current time, patient is stable and awaiting transfer.

Prior Events: Patient has been a resident of the nursing home for 2 years. Her chronic kidney disease has been managed with medication and regular check-ups. No recent changes in her condition except for the last 24 hours. Last blood work was 2 weeks ago, showed stable kidney function. Last medical check-up was 1 week ago.

Diagnostics

Initial Assessment

Initial Impression: Chronic Kidney Disease Exacerbation
Justification for F3 Classification:
- Patient is stable but requires transfer for further evaluation of chronic condition
- Time-sensitive but not life-threatening condition
- Transfer is for diagnostic purposes, not immediate intervention

Differential Diagnoses:
1. Chronic Kidney Disease Exacerbation (high probability)
2. Dehydration (less likely given no reported vomiting or diarrhea)
3. Infection (less likely given no fever or other signs of infection)
4. Medication side effects (less likely, no recent changes in medication)

Required Actions:
- Dispatch of ground EMS with BLS capabilities
- Ensure patient comfort during transfer
- Provide medical documentation to receiving hospital
- Monitor patient's condition during transfer

Final Diagnosis

Final Diagnosis: Chronic Kidney Disease Exacerbation with Mild Anemia
Key Findings:
- Blood work at the receiving hospital showed elevated creatinine and BUN levels
- Mild anemia was also detected
- No other acute issues were identified

Outcome validated F3 priority assignment. Patient's condition was stable and transfer was completed without incident. Patient received appropriate medical attention at the receiving hospital.

Learning Points:
1. F3 classification appropriate due to the need for timely but not emergent intervention
2. Initial assessment accurately identified the need for further evaluation of the chronic condition
3. Detailed patient history and medication list were crucial for appropriate care

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller This is Guðrún from the nursing home in Höfn. We need a transfer for one of our residents.

Dispatcher Okay, can you provide me with the resident's name and date of birth?

Caller It's Guðrún Jónsdóttir, date of birth is April 12, 1968.

Dispatcher And what is the reason for the transfer?

Caller She needs further evaluation of her chronic kidney disease. The doctor wants her seen in Egilsstaðir.

Dispatcher Is she stable right now?

Caller Yes, she is stable, alert and talking. She's just been feeling tired and not eating much.

Dispatcher Okay, I'm scheduling a transfer for her. Please have her medical records ready for the crew.

Caller Okay, we will do that. Thank you.