Emergency Scenario 900_f3

Location Information

Full Location:

Heimagata 7, 900 Vestmannaeyjar. Single-story residential building, concrete construction, built in 1985. Main entrance is at ground level, no steps. No security features. Street parking available. Current conditions: 8°C, overcast, light wind, good visibility. GPS coordinates: 63.4414° N, 20.2723° 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:

70-year-old male, scheduled transfer from home to Vestmannaeyjar Hospital for routine medical evaluation. Patient has chronic kidney disease and is scheduled for dialysis. Patient is stable, alert, and oriented. Primary symptom is fatigue. Patient is wheelchair bound and requires assistance with transfer. Medical history: Chronic Kidney Disease, Type 2 Diabetes, Hypertension. Medications: Insulin 10 units twice daily, Metformin 500mg twice daily, Amlodipine 5mg daily, Erythropoietin injection weekly. Allergies: No known allergies. Last meal: Light lunch at 12:00, small sandwich and tea.

History of Events

Timeline:
1300 hours: Patient reports feeling slightly more fatigued than usual.
1315 hours: Home nurse arrives for scheduled visit, assesses patient, and decides on transfer for evaluation and dialysis.
1330 hours: Nurse contacts emergency services for routine transfer.
1345 hours: Current time, patient is stable, awaiting transfer.

Prior Events: Patient has been managing chronic kidney disease at home with regular home nurse visits and scheduled dialysis at Vestmannaeyjar Hospital. No recent hospitalizations or changes in medication. Last dialysis was 3 days ago. No recent falls or injuries. Patient lives with his wife who is also elderly but able to provide minimal assistance.

Diagnostics

Initial Assessment

Initial Impression: Routine Medical Evaluation Transfer for Chronic Kidney Disease
Justification for F3 Classification:
- Patient is stable with a known chronic condition requiring scheduled evaluation
- No acute symptoms or immediate life threats are present
- Transfer is required for routine medical care (dialysis) and evaluation
- Standard response time is appropriate given the patient's condition

Differential Diagnoses:
1. Chronic Kidney Disease Exacerbation (low probability, no acute symptoms)
2. Hypoglycemia (low probability, patient is not reporting symptoms and has eaten recently)
3. Dehydration (low probability, patient has been drinking fluids)

Required Actions:
- Dispatch of BLS ambulance for routine transfer
- Ensure patient is comfortable during transfer
- Transport to Vestmannaeyjar Hospital for scheduled dialysis and medical evaluation

Final Diagnosis

Final Diagnosis: Routine Medical Evaluation Transfer for Chronic Kidney Disease
Key Findings:
- Patient's condition remained stable throughout the transfer
- Vital signs were within patient's baseline parameters
- No acute issues were identified during the transfer or upon arrival at the hospital

Outcome validated F3 priority assignment. Patient received dialysis as scheduled and was evaluated by the medical team. No changes in his chronic condition were noted. 

Learning Points:
1. F3 classification was appropriate for this routine transfer
2. Accurate information from home nurse facilitated smooth transfer
3. Importance of understanding patient's chronic condition and scheduled care

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller Hello, this is Guðrún Jónsdóttir, I'm a home nurse. I need a transfer for my patient, Jón Einarsson.

Dispatcher Okay, what is the address?

Caller It's Heimagata 7 in Vestmannaeyjar.

Dispatcher And what is the reason for the transfer?

Caller Mr. Einarsson has chronic kidney disease and needs to go to the hospital for his scheduled dialysis and a routine evaluation. He's stable but a bit more tired than usual today.

Dispatcher Is he alert and oriented?

Caller Yes, he is. He's just a bit weak. He is wheelchair bound and needs assistance with transport.

Dispatcher Does he have any other medical conditions or allergies?

Caller He has type 2 diabetes and hypertension. He takes insulin, metformin, amlodipine, and erythropoietin. No known allergies.

Dispatcher Okay, an ambulance will be dispatched for a routine transfer. Please make sure he is ready for transport.

Caller Alright, thank you. We will be waiting.