Emergency Scenario 780_f3

Location Information

Full Location:

Hafnarbraut 12, 780 Höfn, single-story building, concrete construction, built in 1985. Main entrance faces the harbor, no security features. Parking is available in front of the building. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 64.2518° N, 15.2075° W. Nearest landmark: Höfn harbor.

Municipality: Höfn

Postal Code: 780

Emergency Details

Type: Infectious Disease Transfer

Priority Level: F3

Response Time Goal: Standard (30-60 minutes)

Description:

76-year-old female, confirmed case of Clostridium difficile infection, requiring transfer from local health center to hospital for further management. Patient is stable but requires IV antibiotics and close monitoring. Primary symptoms: Persistent diarrhea, abdominal pain. Secondary symptoms: Mild dehydration, low-grade fever. Patient alert and oriented. Medical history: Type 2 diabetes, previous hospitalization for pneumonia 6 months ago. Medications: Metformin 500mg twice daily, Insulin 10 units daily, Vancomycin 125mg four times daily. No known allergies. Last meal was a light lunch at 13:00.

History of Events

Timeline:
1000 hours: Patient reported increased diarrhea frequency and abdominal pain to health center nurse.
1100 hours: Stool sample taken, later confirmed C. difficile infection.
1200 hours: Patient started on oral Vancomycin.
1400 hours: Patient condition remains stable, decision made for transfer to hospital.
1430 hours: Current time, awaiting ambulance transfer. Patient is stable, IV access established, receiving maintenance fluids.

Prior Events: Patient was treated for a UTI 2 weeks ago with oral antibiotics. Recent travel: None. Last medical check-up 1 month ago, routine diabetic follow-up.

Diagnostics

Initial Assessment

Initial Impression: Confirmed Clostridium difficile Infection requiring transfer.
Justification for F3 Classification:
- Patient is stable but requires specialized care and IV treatment not available at the local health center.
- Condition is not immediately life-threatening but requires timely transfer to prevent complications.
- Response time is standard, reflecting the non-urgent nature of the transfer.

Differential Diagnoses:
1. Clostridium difficile infection (confirmed)
2. Other infectious causes of diarrhea (ruled out by testing)
3. Dehydration (mild, currently being addressed with IV fluids)
4. Complications of diabetes (stable, no acute issues)

Required Actions:
- Dispatch of ground ambulance for non-emergency transfer
- Monitoring of vital signs during transport
- Ensuring IV access remains patent
- Transfer to hospital with infectious disease capabilities

Final Diagnosis

Final Diagnosis: Clostridium difficile Colitis
Key Findings:
- Stool sample confirmed the presence of C. difficile toxin.
- Patient's symptoms were consistent with C. difficile infection.
- Patient's condition remained stable throughout the transfer.
- Hospital confirmed the need for continued IV antibiotics and monitoring.

Outcome validated F3 priority assignment. Transfer was completed without incident, and patient received appropriate care at the hospital.

Learning Points:
1. F3 classification appropriate for stable patients requiring transfer for specialized care.
2. Initial assessment accurately identified the need for transfer based on the confirmed diagnosis and limitations of local facilities.
3. Detailed transfer plan ensured patient safety and continuity of care.

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller This is Guðrún from the health center in Höfn. We need an ambulance for a patient transfer.

Dispatcher Okay, can you provide the patient's details and the reason for the transfer?

Caller The patient is Guðrún Jónsdóttir, born ******-****. She has a confirmed C. difficile infection and needs to be transferred to the hospital.

Dispatcher Is the patient stable?

Caller Yes, she is stable. She has been started on Vancomycin and is receiving IV fluids. She is alert and oriented.

Dispatcher Does she have any other medical conditions?

Caller Yes, she has type 2 diabetes and was hospitalized for pneumonia six months ago. She is on Metformin and Insulin.

Dispatcher Okay, an ambulance is being dispatched for a non-emergency transfer. Please keep monitoring her until they arrive.

Caller Alright, thank you. We will be ready.