Emergency Scenario 700_f4

Location Information

Full Location:

Héraðssjúkrahúsið í Austurland, Lyngás 1, 700 Egilsstaðir. Single-story hospital building with multiple wings. Main entrance accessible via ramp. Multiple parking areas. Hospital has internal security protocols. Current conditions: 8°C, clear skies, good visibility. GPS coordinates: 65.2657° N, 14.3948° W. Nearest landmark: Egilsstaðir Airport.

Municipality: Egilsstaðir

Postal Code: 700

Emergency Details

Type: Post-Operative Transfer

Priority Level: F4

Response Time Goal: Routine (1-4 hours)

Description:

72-year-old male, post-operative day 3 following total knee arthroplasty. Patient is stable and requires transfer to rehabilitation center in Reykjavík. No acute complaints. Patient is currently in Héraðssjúkrahúsið í Austurland. Patient is ambulatory with crutches. Pain is well-controlled with oral analgesics. No signs of infection. Patient is compliant and understands the transfer plan. Medical history: Osteoarthritis, hypertension, hyperlipidemia. Medications: Paracetamol 1000mg QID, Atorvastatin 20mg daily, Lisinopril 10mg daily. No known allergies. Last meal was a light lunch at 12:00.

History of Events

Timeline:
Day 1 (3 days ago): Patient underwent total knee arthroplasty, procedure uneventful. 
Day 2 (2 days ago): Patient ambulated with assistance, pain controlled with analgesics. 
Day 3 (today): Patient is stable, pain well-controlled, ready for transfer to rehabilitation center. 

Prior Events: Patient has a history of osteoarthritis in both knees, which led to the decision for surgery. Hypertension and hyperlipidemia are managed with medications. No recent illnesses or injuries. Routine follow-up with orthopedic surgeon scheduled in 2 weeks. Patient lives alone, but family is aware of transfer.

Diagnostics

Initial Assessment

Initial Impression: Post-Operative Transfer, Stable
Justification for F4 Classification:
- Patient is stable, no acute medical issues.
- Transfer is for rehabilitation, not emergency medical care.
- Routine transfer criteria met, no time-critical interventions required.

Differential Diagnoses:
1. Post-operative pain (well-controlled with medication)
2. Surgical site infection (no signs of infection)
3. DVT (no signs of DVT)
4. PE (no signs of PE)

Required Actions:
- Scheduled transfer to rehabilitation center in Reykjavík.
- Ensure patient's medication and medical records are transferred.
- Confirm patient's comfort and stability prior to transport.
- Coordinate transfer with receiving facility.

Final Diagnosis

Final Diagnosis: Post-Operative Status, Stable for Transfer
Key Findings:
- Patient's condition remains stable throughout the transfer process.
- Surgical site clean, no signs of infection.
- Patient's pain controlled with oral analgesics.
- No adverse events during transfer.

Outcome validated F4 priority assignment. Transfer was completed smoothly and patient arrived at rehabilitation center without incident.

Learning Points:
1. F4 classification appropriate for stable post-operative transfers.
2. Pre-transfer assessment accurately identified patient's stability.
3. Coordination between facilities is essential for smooth transfers.

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller Good morning, this is Guðrún Jónsdóttir from Héraðssjúkrahúsið í Austurland. We need to arrange a routine transfer for a post-operative patient.

Dispatcher Okay, I understand. Can you give me the patient's name and social security number?

Caller Yes, it's Jón Einarsson, kennitala is ******-****.

Dispatcher And what is the reason for the transfer?

Caller He is post-operative day three following a total knee replacement and needs to go to a rehabilitation center in Reykjavík. He's stable and doing well.

Dispatcher Okay, is he ambulatory?

Caller Yes, he can walk with crutches. His pain is well-controlled with oral medication.

Dispatcher Does he have any other medical conditions or allergies?

Caller He has hypertension and hyperlipidemia, but these are managed with medications. No known allergies.

Dispatcher Okay, I'll arrange for a routine transfer. It should be within the next 1-4 hours. Is there anything else?

Caller No, that's all. Thank you for your help.

Dispatcher You're welcome. Goodbye.