Emergency Scenario 600_f4

Location Information

Full Location:

Hlíðarvegur 23, 600 Akureyri, ground floor, room 104. Single-story rehabilitation center, built in 1995. Main entrance with automatic doors. Multiple exits. No security codes. Parking lot in front. Weather is clear, 8°C, good visibility. GPS coordinates: 65.6788° N, 18.0879° W. Nearest landmark: Akureyri Hospital.

Municipality: Akureyri

Postal Code: 600

Emergency Details

Type: Rehabilitation Transfer

Priority Level: F4

Response Time Goal: Routine (1-4 hours)

Description:

68-year-old male, post-operative rehabilitation transfer from Akureyri Rehabilitation Center to his home in the same city. Patient is stable, ambulatory with walker assistance. Transfer required due to completion of rehabilitation program. Primary symptom: Mild discomfort at surgical site. Patient is alert and cooperative. Medical history: Total hip replacement 6 weeks ago, hypertension, type 2 diabetes. Medications: Metformin 500mg twice daily, Lisinopril 10mg daily, Paracetamol 1000mg as needed. No known allergies. Last meal was lunch at 12:00.

History of Events

Timeline:
0800 hours: Patient had breakfast and took medications
1000 hours: Patient completed physical therapy session
1200 hours: Patient had lunch
1300 hours: Patient was cleared for discharge by rehabilitation physician
1315 hours: Patient is ready for transport

Prior Events: Patient underwent a total hip replacement 6 weeks ago due to severe osteoarthritis. Post-operative course was uneventful, and patient has made good progress in rehabilitation. No recent illnesses or injuries. Last medical check-up was yesterday with rehabilitation physician.

Diagnostics

Initial Assessment

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

Differential Diagnoses:
1. Routine Post-operative Transfer (high probability)
2. Surgical Site Infection (low probability, no signs of infection)
3. Thromboembolic Event (low probability, no signs of DVT or PE)
4. Medication Side Effects (low probability, patient has been on medications without issues)

Required Actions:
- Dispatch of non-emergency transport unit
- Ensure patient comfort during transport
- Verify discharge instructions and medications with patient and receiving facility (home)

Final Diagnosis

Final Diagnosis: Routine Post-operative Rehabilitation Transfer
Key Findings:
- Physical examination at transfer showed no acute medical issues.
- Surgical site was clean, dry, and well-approximated.
- Patient's vital signs were stable.
- Patient reported mild discomfort controlled with paracetamol.

Outcome validated F4 priority assignment. The transfer was completed without incident.

Learning Points:
1. F4 classification was appropriate due to the stable nature of the patient and routine transfer requirements.
2. Initial assessment accurately identified the patient's condition and needs.
3. Clear communication between the rehabilitation center and transport team ensured a smooth transfer.

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller This is Jónas Einarsson calling from the rehabilitation center, Hlíðarvegur 23. We need a transport for a patient going home.

Dispatcher Okay, can you provide the patient's name and date of birth?

Caller The patient is Jón, Jónsson, kennitala is ******-****. He's 68 years old.

Dispatcher What is the reason for the transport?

Caller He has completed his rehabilitation program after a hip replacement and is being discharged home.

Dispatcher Is the patient stable?

Caller Yes, he is stable. He can walk with a walker, and he’s ready to go.

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

Caller He has hypertension and type 2 diabetes. He takes medications for both, and also paracetamol for mild pain.

Dispatcher Okay, a non-emergency transport will be arranged. Please ensure the patient is ready and has all his discharge papers. We expect it to be within the next few hours.

Caller Thank you, we will wait here. He's all set to go.