Emergency Scenario 600_f4

Location Information

Full Location:

Sjúkrahúsið á Akureyri, Eyrarlandsvegur, 600 Akureyri. Main hospital building, patient transfer from surgical ward, third floor, room 312. Main entrance is accessible via ramp and automatic doors. Multiple elevators and stairwells available. Parking available in designated hospital parking lots. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6719° N, 18.0911° 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:

72-year-old female, post-operative transfer from surgical ward to rehabilitation center. Patient is stable, alert, and oriented. Primary need is transport to Grensás Rehabilitation Center in Reykjavik. Patient underwent a total hip replacement 4 days ago. Surgical site is clean, dry, and intact. Pain is well controlled with oral analgesics. Patient has full range of motion of the operated hip within post-operative limits. No signs of infection or complications. Patient has no other significant medical concerns requiring immediate attention.

History of Events

Timeline:
Day 1: Patient admitted for elective total hip replacement
Day 2: Successful total hip replacement surgery
Day 3: Post-operative recovery, pain well controlled, physiotherapy initiated
Day 4: Patient stable, cleared for transfer to rehabilitation center

Prior Events: Patient had osteoarthritis of the right hip for several years. Pre-operative assessments normal. No history of cardiac or respiratory issues. No allergies reported. Medications: Paracetamol 1000mg qid, Oxycodone 5mg prn. Last meal was a light lunch at 12:00. Patient has been ambulating with assistance and is able to transfer with minimal help.

Diagnostics

Initial Assessment

Initial Impression: Stable Post-Operative Transfer
Justification for F4 Classification:
- Patient is clinically stable with no acute medical concerns
- Transfer is routine and non-urgent
- Patient has undergone a planned surgical procedure and is recovering as expected

Differential Diagnoses:
1. Post-operative pain (controlled)
2. Risk of infection (low, no signs present)
3. Risk of DVT (low, patient is mobile)
4. Adverse reaction to medications (unlikely, patient tolerating medications well)

Required Actions:
- Arrange routine non-emergency transport to Grensás Rehabilitation Center
- Ensure patient comfort during transfer
- Transfer all necessary medical records and discharge summary

Final Diagnosis

Final Diagnosis: Post-Operative Status, Total Hip Replacement, Stable for Transfer
Key Findings:
- Physical examination confirmed stable condition, no signs of complications
- Surgical site clean and dry
- Patient pain well controlled
- No other medical concerns identified

Outcome validated F4 priority assignment. Transfer was completed without incident. Patient continued rehabilitation at Grensás.

Learning Points:
1. F4 classification was appropriate due to the stable and non-urgent nature of the transfer
2. Dispatch assessment aligned with the clinical assessment
3. Proper pre-transfer planning ensured a smooth and safe transport

Emergency Call Transcript

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

Caller Hello, this is Hildur Jónsdóttir from the surgical ward at Akureyri Hospital. We need a routine transfer for a post-operative patient.

Dispatcher Okay, can you provide the patient's details and where she needs to be transferred?

Caller Yes, the patient is a 72-year-old female, name is not relevant, she had a total hip replacement four days ago and is stable for transfer to Grensás Rehabilitation Center in Reykjavik.

Dispatcher Alright, is the patient currently stable, and are there any immediate medical concerns?

Caller Yes, she is stable. Her pain is well managed with oral medications, and the surgical site is clean. No signs of infection or complications. She's fully alert and oriented.

Dispatcher Okay, and what medications is she currently on?

Caller She's on Paracetamol 1000mg four times a day and Oxycodone 5mg as needed for breakthrough pain.

Dispatcher Understood. We'll arrange a routine transfer for her. Can you confirm she has all the necessary medical records for transfer?

Caller Yes, we have her discharge summary and all relevant records ready to go. When can we expect the transport?

Dispatcher We will arrange for transport within the next 1 to 4 hours. We will notify you once the transport team is en route. Is there anything else?

Caller No, that is all. Thank you.