Emergency Scenario 900_f3

Location Information

Full Location:

Heimagata 7, 900 Vestmannaeyjar. Single-story residential house, built in 1965, concrete structure. Main entrance faces the street, no steps. Street parking available. No security features. Current conditions: 8°C, overcast, moderate wind, good visibility. GPS coordinates: 63.4416° N, 20.2745° W. Nearest landmark: Vestmannaeyjar Swimming Pool.

Municipality: Vestmannaeyjar

Postal Code: 900

Emergency Details

Type: Medical Evaluation Transfer

Priority Level: F3

Response Time Goal: Standard (30-60 minutes)

Description:

75-year-old male, post-operative patient requiring transfer from local health center to Landspítali in Reykjavík for specialized evaluation. Patient is stable, but requires continuous monitoring. Primary symptoms: Post-operative weakness and mild fatigue following appendectomy 3 days ago. No active bleeding or infection. Secondary symptoms: Mild discomfort at the surgical site, controlled with oral analgesics. Patient is alert, oriented, and cooperative. Vital signs stable: BP 130/80, HR 78, RR 18, SpO2 97% on room air. Patient is currently in a hospital bed at the Vestmannaeyjar Health Center. Medical history: Appendectomy 3 days ago, type 2 diabetes (well-controlled), mild hypertension. Medications: Metformin 500mg twice daily, Lisinopril 10mg daily, Paracetamol 500mg as needed for pain. No known allergies. Last meal was a light breakfast at 07:00.

History of Events

Timeline:
3 days ago: Patient underwent appendectomy at Vestmannaeyjar Health Center.
Post-op Day 1-2: Patient recovered well, mild post-operative pain controlled with analgesics.
Today: Patient has been cleared for transfer to Landspítali for further evaluation by a specialist due to some persistent fatigue and weakness. No acute changes in condition.

Prior Events: Patient was diagnosed with type 2 diabetes 5 years ago, well-controlled with medication. Diagnosed with hypertension 3 years ago, well-controlled with medication. No other significant medical events. Last check-up was 1 week ago before surgery.

Diagnostics

Initial Assessment

Initial Impression: Post-Appendectomy Transfer for Further Evaluation
Justification for F3 Classification:
- Patient is stable, no acute distress, no signs of active infection or bleeding.
- Transfer is for further evaluation, not an emergency situation.
- Condition is time-sensitive but not life-threatening. Standard response time is appropriate.

Differential Diagnoses:
1. Post-operative weakness (primary concern)
2. Post-operative fatigue (secondary concern)
3. Mild post-operative pain (well-controlled)
4. Possible underlying metabolic issues (less likely, but requires further evaluation)

Required Actions:
- Dispatch of ground ambulance with BLS capabilities
- Patient transfer to Landspítali for specialist evaluation
- Continuous monitoring of vital signs during transfer
- Ensure all patient records and medications are transferred with patient

Final Diagnosis

Final Diagnosis: Post-Appendectomy Recovery with Mild Deconditioning
Key Findings:
- Specialist evaluation at Landspítali confirmed no complications from appendectomy.
- Patient's fatigue and weakness attributed to post-operative deconditioning.
- Blood work showed no signs of infection or metabolic imbalances.

Outcome validated F3 priority assignment. Routine transfer was appropriate. Patient was discharged home after a few days of observation and physical therapy.

Learning Points:
1. F3 classification was appropriate for a stable patient requiring transfer for further evaluation
2. Initial assessment accurately identified the patient's stable condition
3. Effective communication between local and referral hospitals ensured smooth transfer

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller This is Guðrún Jónsdóttir calling from the Vestmannaeyjar Health Center. We need to arrange a transfer for a patient to Landspítali.

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

Caller The patient is a 75-year-old male, he had an appendectomy three days ago. He's stable but we need him seen by a specialist in Reykjavík for further evaluation due to some fatigue and weakness.

Dispatcher Is he currently stable and what are his vital signs?

Caller Yes, he is stable. His blood pressure is 130 over 80, heart rate is 78, respiration is 18, and his oxygen saturation is 97 percent on room air.

Dispatcher Okay, and what is his medical history?

Caller He has type 2 diabetes and hypertension, both well-controlled. He takes metformin, lisinopril, and paracetamol as needed. No known allergies.

Dispatcher Alright, we'll arrange a transfer for him. It will be a standard response time. Please ensure his medical records and medications are ready for the transfer team.

Caller Understood, thank you. We will have everything prepared.