Emergency Scenario 900_f3

Location Information

Full Location:

Hamarstígur 7, 900 Vestmannaeyjar. Two-story residential house built in 1985. Main entrance on the ground floor, no elevator. Parking on the street. No security features. Current conditions: 8°C, overcast, light wind, good visibility. GPS coordinates: 63.4408° N, 20.2679° W. Nearest landmark: Vestmannaeyjar Hospital.

Municipality: Vestmannaeyjar

Postal Code: 900

Emergency Details

Type: Medical Evaluation Transfer

Priority Level: F3

Response Time Goal: Standard (30-60 minutes)

Description:

65-year-old female, requires transfer from home to Vestmannaeyjar Hospital for further evaluation of ongoing abdominal pain. Patient reports discomfort has been present for 3 days, with increasing intensity today. Patient is conscious, alert, and able to communicate clearly. No acute distress. Vitals stable: HR 78, BP 130/80, RR 16, SpO2 97% on room air. No fever. Medical history includes type 2 diabetes and mild hypertension. Medications include Metformin 500mg BID and Lisinopril 10mg daily. No known allergies. Last meal was a light lunch at 13:00.

History of Events

Timeline:
3 days ago: Patient reports mild, intermittent abdominal discomfort, rated 3/10.
2 days ago: Pain increased to 4/10, no other symptoms.
Yesterday: Pain increased to 5/10, patient took over-the-counter pain medication with minimal relief.
This morning: Pain increased to 6/10, patient contacted primary care physician who recommended transfer for further evaluation.
14:30: Patient called emergency services at the request of her doctor for transport.

Prior Events: Patient reports history of mild, infrequent abdominal discomfort, never requiring medical intervention. No recent infections or changes in diet. Last medical check-up 6 months ago for routine diabetes management. Patient lives with her husband, who is available to assist.

Diagnostics

Initial Assessment

Initial Impression: Non-acute Abdominal Pain requiring medical evaluation
Justification for F3 Classification:
- Stable vital signs, no acute distress
- Pain is sub-acute, not immediately life-threatening
- Transfer is for evaluation, not immediate emergency care

Differential Diagnoses:
1. Gastroenteritis (less likely given duration and lack of associated symptoms)
2. Diverticulitis (possible, requires further evaluation)
3. Biliary Colic (possible, requires further evaluation)
4. Non-specific Abdominal Pain (possible, requires further evaluation)
5. Bowel obstruction (less likely, no vomiting or distention reported)

Required Actions:
- Dispatch of basic life support ambulance for non-emergency transfer
- Monitoring of patient's condition during transport
- Transport to Vestmannaeyjar Hospital for further evaluation and management

Final Diagnosis

Final Diagnosis: Acute Diverticulitis
Key Findings:
- CT scan revealed inflammation of the sigmoid colon with diverticula
- Patient's pain score increased during observation at hospital
- Blood tests showed elevated inflammatory markers

Outcome: F3 priority assignment was appropriate for initial presentation. Further diagnostic testing at the hospital revealed a specific condition requiring treatment.

Learning Points:
1. Initial presentation of abdominal pain can be non-specific, requiring further evaluation
2. Sub-acute symptoms can mask more significant underlying pathology
3. F3 classification appropriate for stable patients requiring evaluation, but not immediate intervention

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller Hello, my name is Guðrún Jónsdóttir. My doctor asked me to call for a transfer to the hospital. I have abdominal pain.

Dispatcher Okay, I understand. Can you tell me your address?

Caller It's Hamarstígur 7, in Vestmannaeyjar.

Dispatcher And what is the reason for the transfer?

Caller I've had abdominal pain for three days, it's getting worse. My doctor wants me checked out at the hospital.

Dispatcher Okay. How would you describe the pain?

Caller It's a dull ache, mostly in my lower abdomen. It's about a 6 out of 10 right now.

Dispatcher Are you experiencing any other symptoms like nausea or fever?

Caller No, just the pain. I'm not nauseous or anything. I did eat lunch around 1 PM.

Dispatcher Do you have any medical conditions or take any medications?

Caller Yes, I have type 2 diabetes and mild hypertension. I take Metformin and Lisinopril.

Dispatcher Okay, I am arranging a transfer for you to Vestmannaeyjar Hospital. Please stay calm and we will be there shortly.

Caller Thank you, I will wait here.