Emergency Scenario 600_f4

Location Information

Full Location:

Sjúkrahúsið á Akureyri, Eyrarlandsvegur, 600 Akureyri. Patient is located in the post-operative recovery ward, room 302. The hospital is a multi-story concrete structure built in 1980 with multiple entrances and exits. Access to the ward is via the main entrance and elevators or stairwells. Security is standard for a hospital setting. Current weather: 8°C, overcast, light breeze. GPS coordinates: 65.6728° N, 18.0928° 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:

67-year-old male, post-operative day 2 following a right total hip arthroplasty. Patient is stable but requires transfer from Akureyri Hospital to his home in Húsavík. Patient is ambulatory with a walker, has no active complaints. Surgical wound is clean, dry, and well-approximated. Pain is controlled with oral analgesics. Patient requires assistance with transfers and activities of daily living. Medical history: Osteoarthritis, hypertension, hyperlipidemia. Medications: Oxycodone 5mg PRN, Acetaminophen 500mg TID, Atorvastatin 20mg daily, Amlodipine 5mg daily. No known allergies. Last meal was lunch at 12:00.

History of Events

Timeline:
0800 hours: Patient was assessed by the surgical team and cleared for discharge.
0900 hours: Transfer request was initiated.
1000 hours: Patient had light breakfast.
1100 hours: Patient is currently stable, awaiting transport. 

Prior Events: Patient underwent elective total hip arthroplasty two days ago, surgery was uncomplicated. Post-operative course has been routine with no complications. Patient has been ambulating with a walker and tolerating oral medications well. Patient lives with his wife, who is able to provide assistance at home.

Diagnostics

Initial Assessment

Initial Impression: Stable post-operative patient requiring routine transfer.
Justification for F4 Classification:
- Patient is hemodynamically stable, afebrile, and has no active medical complaints.
- Patient is ambulatory with assistance, and pain is well-controlled.
- Transfer is for convenience and does not require immediate medical intervention.

Differential Diagnoses:
1. Post-operative pain (well controlled)
2. Surgical site infection (no signs or symptoms)
3. Deep vein thrombosis (no signs or symptoms)
4. Pulmonary embolism (no signs or symptoms)

Required Actions:
- Scheduled ground transport with appropriate patient handling equipment.
- Transfer documentation including discharge instructions and medication list.
- Communication with receiving facility (home setting) to confirm arrival time.

Final Diagnosis

Final Diagnosis: Stable post-operative patient, status post right total hip arthroplasty, ready for routine transfer.
Key Findings:
- Patient remains stable with no change in condition during transfer.
- Surgical wound is clean, dry, and well-approximated.
- Patient tolerates transfer without complications.

Outcome validated F4 priority assignment. Transfer was completed without incident. Patient was safely discharged to home.

Learning Points:
1. F4 classification was appropriate based on patient stability and lack of acute medical needs.
2. Thorough assessment and documentation of patient's condition is crucial for safe transfer.
3. Communication with both sending and receiving facilities is important for a smooth transfer process.

Emergency Call Transcript

Dispatcher Emergency services, this is dispatch, what is your emergency?

Caller Good morning, this is Hildur Jónsdóttir from the surgical ward at Akureyri Hospital. We need to arrange a routine transport for a post-operative patient.

Dispatcher Okay, can you provide me with the patient's information?

Caller Yes, the patient's name is Jón Einarsson, kennitala is ******-****. He is post-op day 2 following a hip replacement.

Dispatcher And what is the current condition of the patient?

Caller He is stable, ambulatory with a walker, no active complaints, wound is clean and dry. Pain is controlled with oral medication. He is ready for discharge to his home in Húsavík.

Dispatcher Understood. This is a routine transfer, correct?

Caller Yes, that is correct. We need a transport that can accommodate a patient using a walker. He will need assistance with transfers.

Dispatcher Okay, we will arrange a transport for you. Expect an ambulance within the next 1 to 4 hours. We will notify you when the crew is on their way.

Caller Perfect, thank you for your help.

Dispatcher You're welcome. We will be in touch.