Emergency Scenario 780_f4

Location Information

Full Location:

Heilsugæslustöðin Höfn, Hafnarbraut 18, 780 Höfn. Single-story medical clinic with multiple entrances, main entrance facing Hafnarbraut. Parking available in front of the building. The building is modern construction, built in 2010. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 64.2535° N, 15.2091° W. Nearest landmark: Höfn Harbour.

Municipality: Höfn

Postal Code: 780

Emergency Details

Type: Post-Operative Transfer

Priority Level: F4

Response Time Goal: Routine (1-4 hours)

Description:

55-year-old female, post-operative day 2 following an uncomplicated laparoscopic cholecystectomy. Patient is stable and afebrile, with minimal pain managed with oral analgesics. Requires transfer from Heilsugæslustöðin Höfn to Landspítali in Reykjavík for further follow-up due to complex pre-existing conditions. Patient is ambulatory with assistance. No acute issues. Transfer is for patient convenience and specialist consultation.

History of Events

Timeline:
Two days prior: Patient underwent elective laparoscopic cholecystectomy at Heilsugæslustöðin Höfn. Post-operative course has been uncomplicated. No fever, no signs of infection. Patient is tolerating oral intake. Minimal pain controlled with paracetamol and ibuprofen. Patient has a history of type 2 diabetes, managed with metformin, and hypertension, managed with lisinopril. Patient also has a history of mild asthma controlled with salbutamol inhaler as needed. Last oral intake was a light breakfast at 08:00. The transfer is planned for 13:00 today.

Diagnostics

Initial Assessment

Initial Impression: Post-operative patient, stable for routine transfer
Justification for F4 Classification:
- Patient is post-operative day 2 from uncomplicated procedure
- Patient is stable, afebrile, with minimal pain
- Transfer is for convenience and specialist consultation, not due to acute deterioration
- No signs of infection or other complications

Differential Diagnoses:
1. Post-operative pain (controlled with oral analgesics)
2. Potential for minor wound infection (no signs at present)
3. Underlying conditions (diabetes, hypertension, asthma) stable and managed

Required Actions:
- Routine transfer by non-emergency transport
- Monitoring of vital signs during transfer
- Continuation of current medications
- Handover to receiving facility with patient's medical records

Final Diagnosis

Final Diagnosis: Stable Post-operative status, routine transfer required.
Key Findings:
- Patient remained stable during transfer with no changes in vital signs
- Surgical wound was clean and dry, with no signs of infection
- Patient reported minimal pain, controlled with oral analgesics
- All pre-existing conditions were stable and well-managed

Outcome validated F4 priority assignment. Transfer was completed without incident. Patient was reviewed by specialist team at Landspítali.

Learning Points:
1. F4 classification was appropriate given the patient's stable condition and routine nature of the transfer
2. Initial assessment accurately identified the lack of acute issues
3. No medical interventions were required during transfer, highlighting the patient's stability.

Emergency Call Transcript

Dispatcher Emergency services, what is your emergency?

Caller This is Guðrún Jónsdóttir calling from Heilsugæslustöðin Höfn. We need a routine transfer for a post-operative patient to Landspítali in Reykjavík.

Dispatcher Okay, can you provide the patient's details and reason for transfer?

Caller The patient is a 55-year-old female, kennitala ******-****. She had a laparoscopic cholecystectomy two days ago. She's stable but needs further follow-up in Reykjavík due to pre-existing conditions.

Dispatcher Is she having any complications or acute symptoms?

Caller No, she's stable, afebrile, and her pain is well controlled with oral medication. She's ambulatory with some assistance. No signs of infection or other complications.

Dispatcher What are her pre-existing conditions?

Caller She has type 2 diabetes, hypertension, and mild asthma. All are well-managed with her usual medications.

Dispatcher Okay, I understand. This is a routine transfer. We will arrange transport within the next 1-4 hours. Is there anything else I need to know?

Caller No, that's all. Thank you.