Emergency Scenario 780_f4

Location Information

Full Location:

Heilbrigðisstofnun Suðurlands, Hafnarbraut 12, 780 Höfn í Hornafirði. Single-story hospital building with multiple entrances. Main entrance is accessible via ramp. Parking available. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 64.2525° N, 15.2095° W. Nearest landmark: Höfn harbor.

Municipality: Höfn

Postal Code: 780

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 a total knee replacement. Patient is stable but requires transfer to a rehabilitation facility in Reykjavík. Patient is currently in a regular ward at the hospital. No acute issues, but requires assistance with mobility and pain management during transport. Patient has a history of osteoarthritis and hypertension.

History of Events

Timeline:
Day 1 post-op: Patient underwent successful total knee replacement. Post-operative pain managed with analgesics.
Day 2 post-op: Patient began physical therapy, tolerated well. Vital signs stable.
Day 3 post-op: Patient is stable, pain controlled. Discharge planned for transfer to rehabilitation center. No complications noted. Patient is ambulatory with assistance, but needs stretcher for transport.

Prior Events: Patient has a history of osteoarthritis, managed with NSAIDs prior to surgery. Hypertension controlled with medication. No other significant medical history. No known allergies. Last meal was breakfast at 08:00. Current time is 10:00.

Diagnostics

Initial Assessment

Initial Impression: Stable Post-Operative Patient for Routine Transfer
Justification for F4 Classification:
- Patient is clinically stable, with no acute medical issues.
- Transfer is for rehabilitation purposes, not for acute medical intervention.
- No time-critical factors are present.

Differential Diagnoses:
- Post-operative pain (well-managed)
- Potential for DVT (low probability, patient is mobile)
- Infection (low probability, no signs or symptoms)

Required Actions:
- Scheduled non-emergency transport with appropriate medical support.
- Pain management during transport.
- Ensure patient comfort and safety during transfer.
- Confirm rehabilitation facility is prepared for patient arrival.

Final Diagnosis

Final Diagnosis: Stable Post-Operative Total Knee Replacement Patient
Key Findings:
- Patient's condition remained stable throughout the transfer process.
- No complications or adverse events during transport.
- Pain was well-controlled with oral analgesics.

Outcome validated F4 priority assignment. The patient was successfully transferred to the rehabilitation facility without any issues. No change in patient's condition from initial assessment to arrival at the rehabilitation center.

Learning Points:
1. F4 classification was appropriate for a stable, non-acute transfer.
2. Pre-transfer assessment was accurate in identifying the patient's stability.
3. Communication with both the sending and receiving facilities ensured a smooth transfer process.

Emergency Call Transcript

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

Caller Good morning, this is Guðrún Jónsdóttir from Heilbrigðisstofnun Suðurlands in Höfn. We need to arrange a non-emergency transfer for a post-operative patient.

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

Caller The patient is a 72-year-old male, post-operative day 3 from a total knee replacement. He's stable but needs transfer to a rehabilitation facility in Reykjavík.

Dispatcher Is the patient stable for transport? Any specific medical needs?

Caller Yes, he's stable. He needs assistance with mobility and pain management during transport. He is ambulatory with assistance but needs a stretcher for the transfer.

Dispatcher Okay, I understand. What is the patient's name and social security number?

Caller His name is [Patient Name] and his social security number is [Patient Kennitala]. He is in the regular ward, room 204.

Dispatcher Alright. We will arrange a routine transfer. Please expect an ambulance within the next 1 to 4 hours. Is there anything else?

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

Dispatcher You're welcome. We will confirm the transfer time shortly.