Emergency Scenario 900_f3

Location Information

Full Location:

Heiðarvegur 2, 900 Vestmannaeyjar. Single-story residential house built in 1965. Main entrance with two steps, no ramp. One main entrance door, no secondary exits. No security features. Current conditions: 8°C, overcast, moderate wind. GPS coordinates: 63.4417° N, 20.2749° 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:

78-year-old male, requires transfer from home to Vestmannaeyjar Hospital for scheduled medical evaluation. Patient is stable but has mobility issues due to recent hip replacement surgery. Primary symptom: Mild discomfort in surgical site, no acute pain. Patient is alert and oriented. Medical history: Recent right hip replacement 2 weeks ago, type 2 diabetes, hypertension. Medications: Metformin 1000mg twice daily, Lisinopril 20mg daily, Paracetamol 500mg as needed for pain. No known allergies. Last meal was lunch at 13:00.

History of Events

Timeline:
1400 hours: Patient contacted his primary care physician for a scheduled post-op check-up.
1415 hours: Doctor advised transfer to Vestmannaeyjar Hospital for evaluation due to mild surgical site discomfort.
1420 hours: Caller contacted emergency services for transfer.
1425 hours: Current time, patient is stable and awaiting transfer.

Prior Events: Patient underwent right hip replacement surgery 2 weeks ago. No post-operative complications until today. Has been managing pain with paracetamol. No recent changes in medication. Regular follow-up with physician for diabetes and hypertension.

Diagnostics

Initial Assessment

Initial Impression: Post-Operative Evaluation Transfer
Justification for F3 Classification:
- Patient is stable with mild discomfort, no acute distress
- Transfer is for scheduled evaluation, not an emergency
- Time-sensitive due to post-operative status, but not life-threatening

Differential Diagnoses:
1. Post-operative discomfort (most likely)
2. Minor surgical site infection (low probability)
3. Deep vein thrombosis (low probability, no signs of swelling or redness)
4. Wound dehiscence (low probability, no signs of opening or drainage)

Required Actions:
- Dispatch of ground EMS for non-emergency transfer
- Monitoring of patient's condition during transfer
- Safe transport to Vestmannaeyjar Hospital

Final Diagnosis

Final Diagnosis: Post-Operative Surgical Site Discomfort
Key Findings:
- Physical examination at hospital showed mild tenderness around the surgical site.
- No signs of infection, DVT, or wound dehiscence.
- Patient's pain was well-controlled with paracetamol.
- X-ray showed no abnormalities with the hip replacement.

Outcome validated F3 priority assignment. The patient's condition was stable and required routine transfer. Further evaluation ruled out any serious complications.

Learning Points:
1. F3 classification appropriate for stable patients requiring non-emergency transfers
2. Initial assessment accurately reflected the patient's stable condition
3. Post-operative discomfort is a common occurrence and requires careful monitoring

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller Hello, my father needs to be transferred to the hospital. It's not an emergency but he needs to go today.

Dispatcher Okay, can you tell me your address and what's going on?

Caller It's Heiðarvegur 2 in Vestmannaeyjar. My father had a hip replacement two weeks ago and his doctor wants him to come in for a check-up because he has some discomfort.

Dispatcher Is he in pain now?

Caller Yes, a little. But he's not in severe pain. He can walk slowly with a cane, but it's better if he is transported.

Dispatcher Is he fully alert and awake?

Caller Yes, he is fully alert. He just needs help getting to the hospital.

Dispatcher Okay, we will arrange for a transfer. Can you tell me his name and date of birth?

Caller His name is Jón Einarsson and his kennitala is ******-****.

Dispatcher Alright, help is on its way. Please stay with him and keep him comfortable.

Caller Okay, thank you.