Emergency Scenario 900_f4

Location Information

Full Location:

Heilsugæslustöð Vestmannaeyja, Bárustígur 11, 900 Vestmannaeyjar. Single-story medical clinic. Main entrance at street level. Wheelchair accessible. Parking available. No known security features. Current conditions: 10°C, overcast, good visibility. GPS coordinates: 63.4406° N, 20.2697° 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:

72-year-old female, post-operative day 2 following a total hip arthroplasty at Landspítali University Hospital in Reykjavík. Patient is stable and afebrile, requiring transfer back to Vestmannaeyjar for continued care. Surgical wound is clean, and patient is tolerating oral intake. Requires assistance with ambulation. Patient is alert and oriented. Medical history: Osteoarthritis, hypertension, hyperlipidemia. Medications: Warfarin 5mg daily, Paracetamol 1000mg PRN, Amlodipine 5mg daily, Atorvastatin 20mg daily. No known allergies. Last meal was a light lunch at 12:00.

History of Events

Timeline:
Day 1 post-op: Patient recovered well from surgery, pain well-controlled with oral analgesics. Mobilized with physical therapy. No complications reported.
Day 2 post-op: Patient is stable, tolerating oral diet, and ready for transfer back to Vestmannaeyjar. No new symptoms or changes in condition. Discharge paperwork completed.
1300 hours: Patient is ready for transfer, awaiting transport. Current time is 1315 hours.
Prior Events: Patient underwent elective total hip arthroplasty due to severe osteoarthritis. Pre-operative assessment was unremarkable. Patient had a previous hip replacement on the left side 10 years ago. No other significant medical events.

Diagnostics

Initial Assessment

Initial Impression: Post-Operative Transfer, Stable
Justification for F4 Classification:
- Patient is clinically stable with no acute medical issues.
- Transfer is routine and not time-critical.
- Patient is post-operative and requires continued care but is not in distress.

Differential Diagnoses:
1. Post-Operative Status (primary condition)
2. Deep Vein Thrombosis (low probability, no signs or symptoms)
3. Surgical Site Infection (low probability, wound is clean)
4. Adverse Drug Reaction (low probability, patient tolerating medications)

Required Actions:
- Arrange for non-emergency transport to Vestmannaeyjar Health Clinic
- Ensure proper patient handover and documentation transfer
- Confirm patient comfort during transfer
- Monitor for any changes in condition during transport

Final Diagnosis

Final Diagnosis: Post-Operative Status, Stable for Transfer
Key Findings:
- Patient remained stable throughout transfer process.
- No new medical issues identified during transit.
- Surgical wound site remained clean and dry.
- Vital signs within normal limits upon arrival at Vestmannaeyjar Health Clinic.

Outcome validated F4 priority assignment. The transfer was completed without incident.

Learning Points:
1. F4 classification was appropriate given the patient's stable post-operative status.
2. Detailed patient history and discharge summary were essential for safe transfer.
3. Pre-transfer communication ensured a smooth transition of care.

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller This is Hildur Jónsdóttir calling from Landspítali, we need to arrange a non-emergency transfer for a patient to Vestmannaeyjar.

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

Caller Yes, the patient is a 72-year-old female, her name is Guðrún Eiríksdóttir, kennitala is ******-****. She is post-operative day two following a hip replacement.

Dispatcher And what is her current condition?

Caller She is stable, afebrile, and tolerating oral intake. She needs assistance with ambulation. The surgical wound is clean. She is ready for discharge and transfer back to Vestmannaeyjar.

Dispatcher Okay, so this is a routine transfer, not an emergency?

Caller Yes, that's correct. She's stable and ready to go. We just need transport to the health clinic in Vestmannaeyjar.

Dispatcher Understood. I'll arrange for non-emergency transport. Please confirm the discharge paperwork is complete.

Caller Yes, all paperwork is ready. Thank you.

Dispatcher You're welcome. The transport will be arranged within the next few hours.