Emergency Scenario 900_f4_5

Location Information

Heilsugæslustöð Vestmannaeyja, Bárustígur 2, 900 Vestmannaeyjar. Single-story medical clinic building, built in 1985, concrete construction. Main entrance facing Bárustígur, wheelchair accessible. Parking available in front of the building. No security codes required during business hours. Current conditions: 10°C, overcast, good visibility. GPS coordinates: 63.4408° N, 20.2755° W. Nearest landmark: Vestmannaeyjar Hospital.

Emergency Details

55-year-old female, post-operative day 3 following a laparoscopic cholecystectomy. Patient is stable, afebrile, with no signs of infection. Incision site is clean, dry, and intact. Patient is tolerating oral fluids and soft diet. Transfer is required to the patient's home in Vestmannaeyjar from the local health clinic for continued recovery. Patient has no significant complaints. Patient is ambulatory and able to assist with transfer. No pain reported.

History of Events

Timeline:
0700 hours: Patient underwent routine laparoscopic cholecystectomy at Vestmannaeyjar Hospital.
0700-1400 hours: Post-operative recovery at hospital, stable condition.
1400 hours: Transferred to Heilsugæslustöð Vestmannaeyja for overnight observation.
1400-1000 next day: Stable condition, no complications, tolerating oral intake, ambulating independently.
1000 hours: Current time, patient is ready for discharge home, requiring non-emergency transport.

Prior Events: Patient has a history of gallstones, no other significant medical history. No known allergies. Medications include Paracetamol 500mg PRN for pain, not required since surgery. Last meal was a soft breakfast at 08:00. No recent illnesses or injuries. Last medical check-up was pre-operative assessment at hospital 2 days ago.

Diagnostics

Initial Assessment

Initial Impression: Post-operative Day 3, stable for transfer.
Justification for F4 Classification:
- Patient is stable, afebrile, with no signs of infection or complications.
- Transfer is routine, non-emergency, and can be completed within 1-4 hours.
- No acute symptoms or concerns are present.

Differential Diagnoses:
1. Normal post-operative recovery (most likely)
2. Post-operative infection (unlikely based on current status)
3. Pain requiring intervention (unlikely, patient is pain-free)
4. Dehydration (unlikely, patient is tolerating fluids well)

Required Actions:
- Dispatch of non-emergency transport service
- Ensure patient comfort during transfer
- Provide patient with discharge instructions and follow-up appointment information

Final Diagnosis

Final Diagnosis: Stable post-operative recovery following laparoscopic cholecystectomy.
Key Findings:
- Physical examination confirmed a stable patient with no complications.
- Incision site was clean, dry, and intact.
- Patient's vital signs were within normal limits (RR 16, HR 72, BP 120/80, Temp 36.8°C).
- Patient reported no pain or other symptoms.

Outcome validated F4 priority assignment. The patient was successfully transferred home without incident.

Learning Points:
1. F4 classification was appropriate due to the patient's stable condition and non-emergency nature of the transfer.
2. Initial assessment accurately reflected the patient's post-operative status.
3. Non-emergency transport was sufficient for this case.

Emergency Call Transcript