Emergency Scenario 900_f4

Location Information

Full Location:

Heilsugæslustöð Vestmannaeyja, Bárustígur 11, 900 Vestmannaeyjar. Single-story medical clinic. Main entrance is accessible via ramp. No security features. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 63.4414° N, 20.2710° 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:

67-year-old female, post-operative transfer from Vestmannaeyjar Health Clinic to Landspítali National University Hospital in Reykjavík. Patient underwent a successful laparoscopic cholecystectomy 24 hours ago. Patient is stable, afebrile, and tolerating oral fluids. Surgical site is clean and dry. Primary reason for transfer is for further monitoring and discharge planning due to complex medical history.

History of Events

Timeline:
24 hours prior: Patient underwent laparoscopic cholecystectomy at Vestmannaeyjar Health Clinic. Procedure was uneventful.
Post-op: Patient recovered well, pain controlled with oral analgesics, tolerating oral fluids. No signs of infection or complications.
1 hour prior: Decision made to transfer patient to Landspítali for continued care and discharge planning due to complex medical history. Patient is currently stable and comfortable.

Prior Events: Patient has a history of type 2 diabetes, hypertension, and chronic kidney disease. She had a previous myocardial infarction 5 years ago. Medications: Metformin 1000mg twice daily, Amlodipine 10mg daily, Atorvastatin 20mg daily, Insulin Glargine 20 units at bedtime. Allergies: Penicillin. Last meal was a light breakfast at 08:00. Last medical check-up was 2 weeks ago, routine follow-up with nephrologist.

Diagnostics

Initial Assessment

Initial Impression: Post-Operative Transfer - Stable Condition
Justification for F4 Classification:
- Patient is stable, afebrile, and post-operative from an elective procedure.
- No acute symptoms or complications reported.
- Transfer is for further monitoring and discharge planning, not for emergency treatment.
- Condition does not pose an immediate threat to life or limb.

Differential Diagnoses:
1. Post-operative recovery (most likely)
2. Potential for delayed surgical complications (low probability given current status)
3. Exacerbation of pre-existing conditions (low probability given current stability)

Required Actions:
- Coordinate routine ground transport with appropriate medical personnel.
- Ensure all necessary medical records and medications are transferred with patient.
- Confirm receiving hospital has bed availability and is aware of patient's medical history.

Final Diagnosis

Final Diagnosis: Post-Laparoscopic Cholecystectomy - Stable for Transfer
Key Findings:
- Patient's vital signs remain stable throughout the pre-transfer period.
- Surgical site is clean and dry, no signs of infection.
- Patient is comfortable and tolerating oral fluids.
- No new complications or exacerbations of pre-existing conditions were noted.

Outcome validated F4 priority assignment. Routine transfer was appropriate given the patient's stable condition and the purpose of the transfer.

Learning Points:
1. F4 classification is appropriate for stable post-operative transfers with no acute complications.
2. Detailed medical history and medication list are crucial for safe transfer.
3. Clear communication between transferring and receiving facilities is essential.

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller This is Hildur calling from the Vestmannaeyjar Health Clinic. We need to arrange a routine transfer for a post-operative patient.

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

Caller The patient is Hildur Jónsdóttir, kennitala ******-****. She had a laparoscopic cholecystectomy yesterday and needs to be transferred to Landspítali for further monitoring due to her complex medical history.

Dispatcher Okay, what is her current condition?

Caller She is stable, afebrile, tolerating oral fluids, and her surgical site is clean. No complications.

Dispatcher Does she have any known allergies or medical conditions?

Caller Yes, she is allergic to penicillin. She also has type 2 diabetes, hypertension, chronic kidney disease, and a history of myocardial infarction. She is on several medications, including Metformin, Amlodipine, Atorvastatin, and Insulin Glargine.

Dispatcher Okay, I will arrange a routine transfer. Please ensure all her medical records and medications are ready. What is your location?

Caller We are at the Vestmannaeyjar Health Clinic, Bárustígur 11. The main entrance is accessible via ramp.

Dispatcher Thank you, the transport will be arranged within the next few hours. We will be in contact with an estimated time of arrival.

Caller Perfect, thank you for your help.