Emergency Scenario 700_f4

Location Information

Full Location:

Héraðssjúkrahúsið í Austurland, Nesvegur 1, 700 Egilsstaðir. Single-story hospital building constructed in 1975, with recent additions. Main entrance is accessible via ramp and automatic doors. Multiple secondary entrances for staff and emergencies. Parking lot adjacent to the building. Equipped with fire alarm and security systems. Current conditions: 8°C, clear skies, good visibility. GPS coordinates: 65.2667° N, 14.3972° 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:

68-year-old male, post-operative day 3 following a total hip arthroplasty. Patient is stable, afebrile, and hemodynamically normal. Requires transfer from Héraðssjúkrahúsið í Austurland to his residence in Seyðisfjörður. Primary complaint: Post-surgical discomfort, controlled with oral analgesics. Patient is mobile with walker assistance. Requires assistance with transfers. No active medical issues. Full post-op assessment has been completed. Patient awaiting discharge.

History of Events

Timeline:
Day 0: Patient underwent total hip arthroplasty without complications.
Day 1-2: Patient recovered well, ambulating with walker assistance, pain well controlled with oral analgesics, no fever or signs of infection.
Day 3: Patient is cleared for discharge pending transfer to his residence. All post-op assessments have been completed, and no new issues identified. Patient reports mild post-operative discomfort, controlled with paracetamol and codeine. No change in vital signs. Patient is eager to return home. Last oral intake was breakfast at 08:00 consisting of toast, skyr and coffee.

Diagnostics

Initial Assessment

Initial Impression: Post-Operative Transfer, Stable
Justification for F4 Classification:
- Patient is stable, afebrile, and hemodynamically normal.
- Patient requires routine transfer for discharge home, no immediate medical concerns.
- Post-operative pain is well controlled with oral analgesics.
- No indication of infection, bleeding, or other complications.

Differential Diagnoses:
1. Post-Operative Pain (confirmed, controlled)
2. Deep Vein Thrombosis (low probability, no signs or symptoms)
3. Surgical Site Infection (low probability, no signs or symptoms)
4. Pulmonary Embolism (very low probability, no respiratory symptoms)

Required Actions:
- Arrange non-emergency transport for patient transfer.
- Ensure patient has discharge instructions and medications.
- Confirm patient's residence is accessible and prepared for his return.

Final Diagnosis

Final Diagnosis: Post-Operative Day 3, Total Hip Arthroplasty, Stable for Discharge
Key Findings:
- Comprehensive post-operative assessment confirms patient's stability.
- Surgical site is clean, dry, and well-approximated.
- No signs of infection, bleeding, or other complications.
- Patient's pain is well-controlled with oral analgesics.

Outcome validated F4 priority assignment. Patient was transferred to his residence without incident.

Learning Points:
1. F4 classification was appropriate for this stable post-operative transfer.
2. Thorough pre-transfer assessment ensured no underlying issues were missed.
3. Efficient coordination between hospital and transport services ensured smooth transfer.

Emergency Call Transcript

Dispatcher Emergency services, this is the dispatch center. What is your emergency?

Caller This is Hjördís Jónsdóttir calling from Héraðssjúkrahúsið in Egilsstaðir. We need a non-emergency transfer for a patient.

Dispatcher Okay, please provide the patient's details and the reason for the transfer.

Caller The patient is a 68-year-old male, kennitala ******-****. He is post-operative day three following a total hip replacement. He is stable and ready for discharge.

Dispatcher What is his primary complaint at this time?

Caller He has mild post-operative discomfort, but it is well-controlled with oral pain medication. He is able to ambulate with a walker.

Dispatcher What is the destination for the transfer?

Caller His residence in Seyðisfjörður. We need to arrange transport for him.

Dispatcher Okay, I will arrange a routine transfer for him. Is there anything else I need to know?

Caller No, that is all. He is stable and has all his discharge instructions. Thank you.

Dispatcher You're welcome. We will be in touch with the transport details shortly.