Emergency Scenario 400_f4_8

Location Information

Hlíðarvegur 17, 400 Ísafjörður. Second floor of the hospital. Concrete building built in 1975, with recent renovations. Main entrance is on the ground floor, accessible by ramp and stairs. Elevator and stairwell provide access to all floors. Hospital has a designated parking area. Weather is currently 8°C, overcast with light rain, good visibility. GPS coordinates: 66.0757° N, 23.1244° W. Nearest landmark: Ísafjörður Hospital.

Emergency Details

72-year-old male, post-operative day 3 following a total hip replacement. Patient is stable, afebrile, with minimal pain controlled by oral analgesics. Requires transfer from Ísafjörður Hospital to his home in the same town. Patient is ambulatory with a walker, has stable vital signs, and no signs of infection or complications. Requires assistance with transport due to mobility limitations.

History of Events

Timeline:
Day 1: Patient underwent elective total hip replacement surgery. Post-operative recovery was uneventful. Pain was managed with IV analgesics.
Day 2: Patient transitioned to oral analgesics. Mobilization with walker commenced. No signs of complications.
Day 3: Patient is stable, pain controlled with oral medication, ambulating with walker. Discharge planned for home transfer. Requires assistance with transportation due to mobility limitations. No changes in condition prior to call.

Prior Events: Patient has a history of osteoarthritis, hypertension, and hyperlipidemia. No known allergies. Medications include: Paracetamol 1000mg QID, Oxycodone 5mg PRN, Atorvastatin 20mg daily, Amlodipine 5mg daily. Last meal was a light breakfast at 08:00.

Diagnostics

Initial Assessment

Initial Impression: Post-operative transfer, stable patient.
Justification for F4 Classification:
- Patient is stable, afebrile, with minimal pain.
- Post-operative course is uncomplicated.
- Transfer is for routine discharge, not an emergency.
- No acute medical concerns or instability.

Differential Diagnoses:
1. Post-operative recovery (confirmed)
2. Surgical site infection (ruled out)
3. DVT/PE (low probability based on clinical presentation)
4. Adverse reaction to medication (ruled out)

Required Actions:
- Arrange non-emergency transport for patient from hospital to home.
- Ensure patient is comfortable and has necessary assistance for transfer.
- Confirm patient has discharge instructions and medications.

Final Diagnosis

Final Diagnosis: Stable Post-Operative Total Hip Replacement Patient
Key Findings:
- Patient remains stable throughout the transfer process.
- No signs of infection, bleeding, or other complications.
- Patient tolerated transfer well, with minimal pain.

Outcome validated F4 priority assignment. Routine transfer was appropriate. Patient was successfully transferred to home.

Learning Points:
1. F4 classification appropriate due to the stable nature of the patient.
2. Initial assessment accurately identified the patient as a routine transfer.
3. No complications arose during the transfer, indicating a well-managed post-operative course.

Emergency Call Transcript