Emergency Scenario 780_f3

Location Information

Full Location:

Hafnarbraut 12, 780 Höfn, ground floor of a single-story concrete building, built in 1990. Main entrance is accessible via a ramp. No elevator. Parking available in front of the building. The building is a clinic, and there are no security features. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 64.2522° N, 15.2088° 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, known case of MRSA infection, currently stable but requires transfer from local clinic in Höfn to Landspítali in Reykjavík for specialized treatment. Patient is alert, oriented, and afebrile. Patient has a history of type 2 diabetes and hypertension. Patient is currently receiving intravenous antibiotics. Patient is mobile with minimal assistance.

History of Events

Timeline:
0800 hours: Patient presented to local clinic with worsening cellulitis on right leg.
0900 hours: Cultures taken, and MRSA confirmed.
1000 hours: Patient started on IV antibiotics.
1100 hours: Patient stabilized, transfer to Landspítali requested.
1130 hours: Current time, awaiting ambulance transfer.

Prior Events: Patient diagnosed with MRSA 2 weeks ago after a surgical site infection. Has been on oral antibiotics which were not effective. Patient has a history of type 2 diabetes and hypertension, well controlled with medication. Last medical check-up 1 week ago for wound care. Patient is a resident of Höfn.

Diagnostics

Initial Assessment

Initial Impression: MRSA Infection, Stable for Transfer
Justification for F3 Classification:
- Patient is stable with no immediate life threats
- Requires transfer for specialized care, but not an emergency
- Time-sensitive due to infection management but not critical for immediate response

Differential Diagnoses:
1. Cellulitis secondary to MRSA (confirmed)
2. Other bacterial infections (ruled out by cultures)
3. Diabetic foot ulcer (ruled out, cellulitis primary)
4. Deep vein thrombosis (ruled out by physical exam)

Required Actions:
- Dispatch of ground ambulance with BLS capabilities
- Ensure IV antibiotics are continued during transport
- Monitor vital signs during transport
- Coordinate transfer with Landspítali

Final Diagnosis

Final Diagnosis: Methicillin-Resistant Staphylococcus Aureus (MRSA) Cellulitis, Stable for Transfer
Key Findings:
- Cultures confirmed MRSA infection
- Patient’s vital signs stable during observation
- No signs of sepsis or systemic infection
- IV antibiotics effectively controlling infection at current time

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

Learning Points:
1. F3 classification was appropriate due to the stable nature of the patient's condition and the need for a routine transfer
2. Dispatch should ensure that the transferring team is aware of the MRSA status and takes appropriate precautions
3. Proper documentation and communication are essential for a safe and effective transfer.

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller This is Guðrún from the clinic in Höfn. We need a transfer for a patient with MRSA.

Dispatcher Okay, can you provide the patient's details and location?

Caller The patient is Guðrún Jónsdóttir, kennitala ******-****. She is at Hafnarbraut 12, in Höfn.

Dispatcher What is her condition?

Caller She has a confirmed MRSA infection. She is stable, but needs transfer to Landspítali for further treatment.

Dispatcher Is she on any medications or IV fluids?

Caller Yes, she is on intravenous antibiotics. She has a history of type 2 diabetes and hypertension.

Dispatcher Okay, we'll arrange for a transfer. Is she mobile?

Caller Yes, she is mobile with minimal assistance. She is currently stable and waiting for the ambulance.

Dispatcher Okay, an ambulance will be dispatched. Please ensure all relevant paperwork is ready.

Caller Thank you, we will. We appreciate the help.