Emergency Scenario 600_f4

Location Information

Full Location:

Sjúkrahúsið á Akureyri, Eyrarlandsvegur, 600 Akureyri, 3rd floor, ward 3C. Modern hospital building with multiple entrances. Main entrance is accessible 24/7. Elevators and stairwells provide access to all floors. Parking available on site. Building equipped with fire alarm and sprinkler system. Current conditions: 7°C, clear skies, good visibility. GPS coordinates: 65.6714° N, 18.0955° W. Nearest landmark: Akureyri Hospital helipad.

Municipality: Akureyri

Postal Code: 600

Emergency Details

Type: Post-Operative Transfer

Priority Level: F4

Response Time Goal: Routine (1-4 hours)

Description:

68-year-old female, post-operative day 2 following a total hip arthroplasty. Patient is stable, afebrile, with minimal pain controlled by oral analgesics. Surgical site is clean, dry, and without signs of infection. Patient is ambulatory with assistance and requires transfer to a rehabilitation facility in Húsavík. Patient has a history of osteoarthritis and hypertension. No known allergies. Medications include paracetamol 1000mg every 6 hours, and enalapril 10mg daily. Last oral intake was a light lunch at 12:00.

History of Events

Timeline:
0800 hours: Patient had breakfast, no issues reported
1000 hours: Patient completed morning physiotherapy session
1200 hours: Patient had lunch, tolerated well
1300 hours: Patient is stable and cleared for transfer to rehabilitation facility.

Prior Events: Patient underwent elective total hip arthroplasty two days prior, procedure was uneventful. Patient has been stable post-operatively, with no complications. No recent illnesses or injuries.

Diagnostics

Initial Assessment

Initial Impression: Stable Post-Operative Transfer
Justification for F4 Classification:
- Patient is stable with no acute medical issues
- Transfer is for rehabilitation, not for acute medical care
- Patient's vital signs are within normal limits
- No evidence of infection, bleeding, or other complications

Differential Diagnoses:
1. Post-operative pain (well-controlled)
2. Deep vein thrombosis (low probability, no signs or symptoms)
3. Surgical site infection (low probability, wound appears clean and dry)
4. Adverse reaction to medication (unlikely, patient is tolerating medications well)

Required Actions:
- Arrange for routine ambulance transfer with BLS capabilities
- Ensure patient's medication and transfer documentation are complete
- Coordinate transfer with rehabilitation facility

Final Diagnosis

Final Diagnosis: Post-Operative Total Hip Arthroplasty, Stable for Transfer
Key Findings:
- Physical examination confirmed stable post-operative status
- Surgical site clean and dry, no signs of infection
- Patient's vital signs stable (HR 78, BP 130/80, RR 16, Temp 36.8°C)
- Patient's pain controlled with oral analgesics
- Patient ambulatory with assistance

Outcome validated F4 priority assignment. Transfer was completed without incident. Patient continued rehabilitation at the Húsavík facility.

Learning Points:
1. F4 classification was appropriate given the patient's stable condition and the non-urgent nature of the transfer.
2. Detailed pre-transfer assessment is crucial to ensure patient safety during transfer.
3. Effective communication between the hospital and rehabilitation facility ensures a smooth transfer process.

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller This is Hildur calling from the Akureyri hospital. We need to arrange a routine transfer for a patient.

Dispatcher Okay, can you give me the patient's details and the location they need to be transferred to?

Caller Yes, the patient is Hildur Jónsdóttir, kennitala ******-****. She needs to be transferred to the rehabilitation facility in Húsavík.

Dispatcher And what is the patient's current condition?

Caller She is post-operative day two after a hip replacement. She is stable, comfortable, and ready for transfer.

Dispatcher Is she having any pain or other symptoms?

Caller She has minimal pain, controlled with oral medication. No other issues.

Dispatcher Okay, I will arrange for a routine transfer. Do you have all the necessary documentation ready?

Caller Yes, everything is prepared. We just need the transport to arrive.

Dispatcher The transport will be there within 1-4 hours. Please make sure the patient is ready when they arrive.

Caller Thank you, we will.