Emergency Scenario 780_f4

Location Information

Full Location:

Heilbrigðisstofnun Suðurlands, Hafnarbraut 2, 780 Höfn í Hornafirði. Main hospital building, single story, concrete structure. Main entrance is accessible via ramp. Parking available in front of building. No security codes required. Current conditions: 8°C, overcast, moderate visibility. GPS coordinates: 64.2504° N, 15.2084° W. Nearest landmark: Höfn Swimming Pool.

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 transfer from Höfn hospital to Reykjavik for further rehabilitation. Patient is stable, alert, and oriented. Primary condition: Status post left total hip arthroplasty (THA) two days ago. No acute complications. Patient has well-healed surgical wound. Patient is mobile with walker. Secondary condition: History of hypertension, managed with medication. No known allergies. Medications: Paracetamol 1g QID, Warfarin 5mg daily, Amlodipine 5mg daily. Last oral intake was breakfast at 07:00.

History of Events

Timeline:
0700 hours: Patient had breakfast, medications given
0800 hours: Patient completed physical therapy session, tolerated well
0900 hours: Discharge orders received, transfer requested to Reykjavik rehabilitation facility
0930 hours: Transfer coordination call initiated

Prior Events: Patient underwent left total hip arthroplasty two days ago. Post-operative course has been uneventful. No complications noted. Patient has been ambulating with walker with assistance from physical therapy. Patient has no prior history of falls or other significant medical events.

Diagnostics

Initial Assessment

Initial Impression: Post-Operative Transfer, Stable
Justification for F4 Classification:
- Patient is stable, alert, and has no acute medical issues
- Transfer is for rehabilitation purposes, not an emergency
- No time-critical elements involved

Differential Diagnoses:
1. Post-operative transfer for rehabilitation (primary)
2. Deep vein thrombosis (low probability, no signs or symptoms)
3. Surgical site infection (low probability, wound is clean and dry)
4. Adverse drug reaction (low probability, patient stable on current medications)

Required Actions:
- Arrange for non-emergency transport to Reykjavik rehabilitation facility
- Ensure all medical records and medications are transferred with the patient
- Confirm patient's comfort and stability during transport
- Provide clear handover to receiving facility

Final Diagnosis

Final Diagnosis: Stable Post-Operative Left THA, Transfer for Rehabilitation
Key Findings:
- Patient's physical exam was normal, surgical wound was clean and dry
- Patient's vital signs were within normal limits (BP 130/80, HR 78, RR 16, SpO2 98% on room air)
- Patient was able to ambulate with walker with minimal assistance

Outcome validated F4 priority assignment. The transfer was completed smoothly with no complications. Patient arrived at rehabilitation facility in stable condition.

Learning Points:
1. F4 classification appropriate due to the stable condition of the patient and non-emergent nature of the transfer
2. Detailed medical history and physical examination were crucial in determining patient's stability
3. Effective communication between transferring and receiving facilities ensured smooth handover

Emergency Call Transcript

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

Caller Hello, this is Guðrún Jónsdóttir from the hospital in Höfn. We need to arrange a routine transfer for a post-operative patient to Reykjavik.

Dispatcher Okay, can you provide me with the patient's details?

Caller Yes, it's a 72-year-old male, kennitala ******-****. He had a left hip replacement two days ago and needs to go to a rehabilitation center in Reykjavik.

Dispatcher Alright, and is the patient stable for transfer?

Caller Yes, he's completely stable. He is alert, oriented, and ambulating with a walker. No complications. He had breakfast and his medications.

Dispatcher Okay, and what medications is he on?

Caller He is on Paracetamol 1g four times a day, Warfarin 5mg daily, and Amlodipine 5mg daily.

Dispatcher Understood. And his last meal was breakfast at 07:00, correct?

Caller Yes, that's correct. We have all the paperwork and his medications ready for the transfer.

Dispatcher Perfect, we will arrange for a non-emergency transport. We'll be in contact with you shortly to confirm the timing.

Caller Thank you, we appreciate it.