Emergency Scenario 900_f4

Location Information

Full Location:

Heilsugæslustöð Vestmannaeyja, Bárustígur 11, 900 Vestmannaeyjar. Single-story medical clinic building. Main entrance at the front, wheelchair accessible. Clinic has a reception area, several examination rooms, and a small treatment room. Parking available in front of the building. Current conditions: 8°C, cloudy, good visibility. GPS coordinates: 63.4417° N, 20.2729° W. Nearest landmark: Vestmannaeyjar Hospital.

Municipality: Vestmannaeyjar

Postal Code: 900

Emergency Details

Type: Post-Operative Transfer

Priority Level: F4

Response Time Goal: Routine (1-4 hours)

Description:

45-year-old male, post-operative day 2 following a laparoscopic appendectomy. Patient is stable with no acute complications. Transfer required to Reykjavík for further recovery and follow-up at Landspítali University Hospital. Patient reports mild post-operative pain controlled with oral analgesics. Patient is ambulatory and has tolerated oral fluids and light diet. No signs of infection or other complications. Patient is currently at the Vestmannaeyjar Health Clinic.

History of Events

Timeline:
48 hours prior: Patient underwent laparoscopic appendectomy at Vestmannaeyjar Hospital. Procedure was uncomplicated.
24 hours prior: Patient was transferred to the local health clinic for continued post-operative care.
Present: Patient is stable, afebrile, with minimal pain, and is being prepared for transfer to Reykjavík.

Prior Events: Patient was previously healthy with no significant medical history. No known allergies. Medications: Paracetamol 500mg every 6 hours as needed for pain. Last oral intake was a light lunch at 12:00. No recent illnesses or injuries. Last medical check-up was the pre-operative assessment 2 days ago.

Diagnostics

Initial Assessment

Initial Impression: Stable Post-Operative Patient for Routine Transfer
Justification for F4 Classification:
- Patient is stable with no acute medical issues or complications
- Transfer is for routine follow-up and further recovery, not for an acute condition
- No immediate medical intervention is required, and transport can be scheduled within 1-4 hours

Differential Diagnoses:
1. Post-operative pain (controlled with oral medication)
2. Potential for infection (no signs or symptoms)
3. Potential for wound complications (no signs or symptoms)
4. Potential for ileus (patient tolerating oral intake)

Required Actions:
- Coordination of non-emergency transfer to Landspítali University Hospital
- Patient comfort during transport
- Monitoring for any changes in condition during transfer

Final Diagnosis

Final Diagnosis: Post-Laparoscopic Appendectomy, Stable for Transfer
Key Findings:
- Patient remained stable throughout the transfer process
- No new complications developed during the transfer
- Physical examination at Landspítali University Hospital confirmed well-healing surgical site and no signs of infection

Outcome validated F4 priority assignment. Routine transfer was appropriate. Patient was discharged home 2 days later.

Learning Points:
1. F4 classification was appropriate given the stable nature of the patient
2. Initial assessment accurately identified the patient as a routine transfer case
3. Careful monitoring during transfer ensured patient safety

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller This is Hildur from Heilsugæslustöð Vestmannaeyja. We need to arrange a routine transfer for a post-op patient to Reykjavík.

Dispatcher Okay, can you give me the patient's name and kennitala?

Caller Yes, it's Einar Ólafsson, kennitala ******-****.

Dispatcher And what is the reason for the transfer?

Caller He had a laparoscopic appendectomy two days ago and is stable. He needs to go to Landspítali for follow-up.

Dispatcher Is the patient stable, any pain or other issues?

Caller Yes, he is stable. Mild pain, but it's controlled with paracetamol. He's eating and drinking okay. No fever or other problems.

Dispatcher Okay, this is classified as 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. We'll have him ready for transport. Thank you.

Dispatcher You're welcome. We will contact you shortly with an estimated time of arrival.