Emergency Scenario 510_f4

Location Information

Full Location:

Hólmavík Hospital, Aðalgata 30, 510 Hólmavík, second floor rehabilitation unit. Two-story concrete building constructed in 1968. Main entrance is accessible via ramp. No elevator, central stairwell. Street parking available. Hospital has fire alarm and emergency lighting systems. Current conditions: 3°C, overcast, moderate visibility, icy patches on pavement. GPS coordinates: 65.4234° N, 21.6878° W. Nearest landmark: Hólmavík Church.

Municipality: Hólmavík

Postal Code: 510

Emergency Details

Type: Rehabilitation Transfer

Priority Level: F4

Response Time Goal: Routine (1-4 hours)

Description:

78-year-old male, status post left hip replacement surgery 3 weeks ago. Patient is stable, requires transfer from Hólmavík Hospital rehabilitation unit to his home in Ísafjörður. Patient is ambulatory with walker, requires assistance with transfers. Patient has a history of osteoarthritis and hypertension. Patient is currently on pain management and anticoagulant therapy. Patient is alert, oriented and cooperative. No acute symptoms reported. Transfer required due to completion of rehabilitation program. Patient's home is not equipped for advanced medical care.

History of Events

Timeline:
3 weeks ago: Patient underwent left hip replacement surgery at Landspítali University Hospital in Reykjavik.
2 weeks ago: Patient transferred to Hólmavík Hospital for rehabilitation.
Present: Patient has completed the rehabilitation program and is stable for discharge to his home in Ísafjörður.

Prior Events: Patient has a history of osteoarthritis for 10 years, managed with NSAIDs. Hypertension diagnosed 5 years ago, managed with Amlodipine. No known allergies. Last meal was breakfast at 08:00. Current medications include Warfarin 5mg daily, Paracetamol 1000mg PRN, Amlodipine 5mg daily. Last PT/INR check was yesterday, within therapeutic range.

Diagnostics

Initial Assessment

Initial Impression: Post-operative rehabilitation transfer, stable condition.
Justification for F4 Classification:
- Patient is stable, ambulatory with assistance, and has completed the rehabilitation program.
- No acute symptoms or medical concerns reported.
- Transfer is routine, not requiring immediate medical intervention.

Differential Diagnoses:
1. Post-operative recovery (primary diagnosis).
2. Stable hypertension (chronic condition, not requiring urgent intervention).
3. Anticoagulant therapy (managed, no active bleeding).

Required Actions:
- Dispatch of non-emergency transport with appropriate equipment for mobility assistance.
- Ensure availability of all discharge documentation and medication list.
- Confirm patient's home is prepared for his return.

Final Diagnosis

Final Diagnosis: Post-operative rehabilitation transfer, stable condition. 
Key Findings:
- Patient's clinical status was stable and consistent with post-operative recovery.
- No complications or adverse events occurred during the transfer.
- Patient tolerated the transfer well and arrived at his home without incident.

Outcome validated F4 priority assignment. Routine transport was appropriate.

Learning Points:
1. F4 classification was appropriate given the patient's stable condition and routine transfer requirements.
2. Detailed communication between the hospital and transport team ensured a smooth and safe transfer.
3. Proper documentation of patient's medical history and medications was crucial for continuity of care.

Emergency Call Transcript

Dispatcher Emergency services, this is the dispatch center, how can I assist you?

Caller Good day, this is Guðrún Jónsdóttir from Hólmavík Hospital. I am calling to arrange a non-emergency transfer for a patient.

Dispatcher Okay, please provide the patient's details and the reason for the transfer.

Caller The patient is Jón Einarsson, kennitala ******-****. He has completed his rehabilitation program after a hip replacement and needs to be transferred to his home in Ísafjörður.

Dispatcher Is the patient stable for transport?

Caller Yes, he is stable. He is ambulatory with a walker but needs assistance with transfers. He is currently on Warfarin, Paracetamol and Amlodipine.

Dispatcher Okay, I will schedule a routine transport for him. Do you have all the necessary discharge paperwork and medications ready?

Caller Yes, everything is prepared. We just need the transport to be arranged within the next few hours.

Dispatcher Understood. I will dispatch a non-emergency transport unit to Hólmavík Hospital. Please confirm the patient's home address in Ísafjörður.

Caller His home address is Aðalstræti 15, 400 Ísafjörður.

Dispatcher Thank you. The transport will be dispatched shortly. Is there anything else?

Caller No, that will be all. Thank you for your help.