Emergency Scenario 600_f4

Location Information

Full Location:

Sjúkrahúsið á Akureyri, Eyrarlandsvegur, 600 Akureyri, second floor, room 215. Modern hospital building, multi-story, concrete construction. Main entrance with automatic doors, multiple access points for staff and ambulances. Security personnel on site. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6703° N, 18.0948° W. Nearest landmark: Akureyri Hospital main entrance.

Municipality: Akureyri

Postal Code: 600

Emergency Details

Type: Post-Operative Transfer

Priority Level: F4

Response Time Goal: Routine (1-4 hours)

Description:

78-year-old male, post-operative day 2 following a total hip replacement. Patient is stable, afebrile, and hemodynamically normal. Requires transfer from Akureyri Hospital to his home in the residential area of Akureyri. Patient is ambulatory with crutches and requires assistance with transport. No active complaints, surgical site is clean, dressing intact. Patient is alert and oriented. Medical history: Osteoarthritis, hypertension, hyperlipidemia. Medications: Acetaminophen 500mg PRN, Warfarin 5mg daily, Atorvastatin 20mg daily. No known allergies. Last meal was lunch at 12:00.

History of Events

Timeline:
0700 hours: Patient received morning medications.
0800 hours: Patient completed physical therapy session with good tolerance.
1000 hours: Patient's discharge was approved by the surgeon.
1100 hours: Discharge paperwork completed, transfer request initiated.
1300 hours: Current time, patient is awaiting transport.

Prior Events: Patient underwent total hip replacement surgery two days prior due to severe osteoarthritis. Post-operative course has been uneventful. No signs of infection or complications. Patient is compliant with all post-operative instructions and has good understanding of home care.

Diagnostics

Initial Assessment

Initial Impression: Stable Post-Operative Transfer
Justification for F4 Classification:
- Patient is hemodynamically stable, afebrile, and has no active complaints.
- Post-operative course has been uneventful with no signs of complications.
- Transfer is routine, does not require immediate medical intervention.

Differential Diagnoses:
1. Post-Operative Pain (ruled out, patient is comfortable)
2. Surgical Site Infection (ruled out, site is clean and dry)
3. DVT/PE (ruled out, no signs or symptoms)
4. Adverse medication effects (ruled out, patient tolerating medications well)

Required Actions:
- Dispatch of non-emergency transport vehicle
- Assistance with patient transfer from hospital to vehicle
- Monitoring of patient during transport
- Safe transfer to patient's home

Final Diagnosis

Final Diagnosis: Stable Post-Operative Patient for Routine Transfer
Key Findings:
- Patient's vital signs are within normal limits.
- Surgical site is clean, dry, and intact.
- Patient is ambulatory with crutches, requiring minimal assistance.
- No new complaints or signs of complications noted during transfer.

Outcome validated F4 priority assignment. Routine transfer was appropriate. Patient was transferred to his home without incident.

Learning Points:
1. F4 classification appropriate for routine, stable post-operative transfers
2. Thorough assessment of patient stability is critical prior to transfer
3. Clear communication between hospital staff and transport team is essential for smooth transfer

Emergency Call Transcript

Dispatcher Emergency services, this is the transfer line. What is the nature of your request?

Caller Hello, this is Hjördís Jónsdóttir from Akureyri Hospital. We need a routine transfer for a post-operative patient.

Dispatcher Okay, can you provide the patient's details and location?

Caller Yes, the patient is Jón Einarsson, kennitala ******-****. He's on the second floor, room 215. He had a hip replacement two days ago and is stable for discharge.

Dispatcher Is the patient ambulatory?

Caller Yes, he is ambulatory with crutches. He just needs assistance with transport.

Dispatcher Does he have any medical conditions or medications we should be aware of?

Caller He has osteoarthritis, hypertension, and hyperlipidemia. He takes acetaminophen as needed, warfarin, and atorvastatin daily. No known allergies.

Dispatcher Okay, and his home address for the transfer?

Caller He lives at Strandgata 22, 600 Akureyri.

Dispatcher Alright, I will schedule a routine transfer. It should arrive within 1-4 hours.

Caller Thank you, we will have him ready.