Emergency Scenario 900_f3

Location Information

Full Location:

Miðhús 2, 900 Vestmannaeyjar. Two-story residential building constructed in 1965. Main entrance on the ground floor, accessible via a small concrete ramp. Building has no elevator. One main stairwell. Street parking available. Current conditions: 8°C, overcast, moderate visibility. GPS coordinates: 63.4405° N, 20.2688° W. Nearest landmark: Vestmannaeyjar swimming pool.

Municipality: Vestmannaeyjar

Postal Code: 900

Emergency Details

Type: Infectious Disease Transfer

Priority Level: F3

Response Time Goal: Standard (30-60 minutes)

Description:

70-year-old female, confirmed case of Norovirus infection, requiring transfer from home to the local health center for IV hydration. Primary symptoms: Severe dehydration, persistent nausea, vomiting, and diarrhea for the past 48 hours. Secondary symptoms: Weakness, dizziness, and decreased urine output. Patient is alert but fatigued. Skin is pale and dry. Patient is currently in her living room. Medical history: Type 2 diabetes, managed with Metformin 500mg twice daily. No known allergies. Last oral intake was a few sips of water at 06:00. Patient is unable to tolerate oral fluids.

History of Events

Timeline:
Day 1, 0800 hours: Onset of nausea and vomiting.
Day 1, 1200 hours: Onset of watery diarrhea.
Day 1, 1800 hours: Symptoms persist, reduced oral intake.
Day 2, 0600 hours: Patient reports severe weakness, dizziness, and minimal urine output. Daughter called for assistance. 
Day 2, 0900 hours: Current time, patient is awaiting transfer.

Prior Events: Patient was seen by her GP yesterday who confirmed Norovirus. No recent hospitalizations. Has been isolating at home since symptoms began. No recent travel history.

Diagnostics

Initial Assessment

Initial Impression: Norovirus infection with moderate dehydration requiring IV hydration.
Justification for F3 Classification:
- Patient has confirmed Norovirus infection with significant symptoms of dehydration.
- Requires medical transfer for IV hydration but is not in a life-threatening condition at the time of call.
- Condition requires timely medical attention but allows for a standard response time.

Differential Diagnoses:
1. Norovirus infection (confirmed)
2. Other viral gastroenteritis (less likely due to confirmed diagnosis)
3. Food poisoning (less likely due to duration and symptom pattern)
4. Complications of diabetes (less likely given the primary symptoms)

Required Actions:
- Dispatch of basic life support ambulance
- Initiate IV hydration upon arrival
- Transport to local health center for further management

Final Diagnosis

Final Diagnosis: Norovirus infection with moderate dehydration.
Key Findings:
- Patient presented with typical symptoms of Norovirus infection.
- Clinical assessment confirmed moderate dehydration based on skin turgor, mucous membrane dryness, and reduced urine output.
- Patient responded well to initial IV hydration.
- No signs of sepsis or other complications were present.

Outcome validated F3 priority assignment. Patient’s condition was as described and responded well to treatment.

Learning Points:
1. F3 classification was appropriate given the non-life-threatening but time-sensitive nature of the case.
2. Initial assessment accurately identified the need for IV hydration.
3. Prompt transfer and fluid administration contributed to patient recovery.

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller My mother needs to be taken to the health center. She has Norovirus and is very dehydrated.

Dispatcher Okay, I'm sending help. What is your address?

Caller It's Miðhús 2 in Vestmannaeyjar.

Dispatcher Help is on its way. Can you tell me what has been happening?

Caller She's been vomiting and having diarrhea for two days. She can't keep any fluids down and is very weak.

Dispatcher Is she awake and talking to you?

Caller Yes, she's awake but very tired. She’s dizzy and has hardly been to the bathroom.

Dispatcher Does she have any medical conditions?

Caller She has diabetes, type 2. She takes Metformin for it.

Dispatcher Okay, the ambulance is on its way. Please stay with her and keep her calm.

Caller Okay, thank you. I will.