Emergency Scenario 900_f4

Location Information

Full Location:

Miðgarður 2, 900 Vestmannaeyjar. Single-story medical clinic building, built in 1995. Main entrance is accessible via ramp. No security features. Current conditions: 10°C, overcast, good visibility. GPS coordinates: 63.4418° N, 20.2702° W. Nearest landmark: Vestmannaeyjar Hospital.

Municipality: Vestmannaeyjar

Postal Code: 900

Emergency Details

Type: Dialysis Patient Transfer

Priority Level: F4

Response Time Goal: Routine (1-4 hours)

Description:

65-year-old male, chronic renal failure, requires routine transfer from Vestmannaeyjar clinic to Landspítali for scheduled dialysis. Patient is stable, ambulatory, and has no acute symptoms. He is scheduled for dialysis at 16:00 today.

History of Events

Patient has a history of end-stage renal disease (ESRD) secondary to diabetic nephropathy, diagnosed 5 years ago. Patient receives hemodialysis three times per week at Landspítali in Reykjavik. He is currently at the Vestmannaeyjar medical clinic for a pre-transfer assessment. Patient reports no changes in condition, no pain, and no shortness of breath. He reports following his dietary restrictions and medication regimen. Last dialysis session was 2 days ago. Last oral intake was a light lunch at 12:00.

Diagnostics

Initial Assessment

Initial Impression: Stable ESRD patient requiring routine dialysis transfer.
Justification for F4 Classification:
- Patient is stable with no acute symptoms or distress
- Transfer is for a scheduled procedure
- No immediate threat to life or health

Differential Diagnoses:
1. ESRD requiring scheduled dialysis (Primary)
2. Fluid overload (unlikely, no reported symptoms)
3. Electrolyte imbalance (unlikely, no reported symptoms)
4. Infection (unlikely, no fever or other signs of infection)

Required Actions:
- Coordinate routine ambulance transfer to Landspítali
- Ensure patient has all necessary documentation
- Confirm transfer time with Landspítali dialysis unit

Final Diagnosis

Final Diagnosis: Stable ESRD patient requiring routine dialysis transfer.
Key Findings:
- Patient assessment confirmed stable condition
- Vital signs within normal limits for patient's baseline
- No acute medical issues identified

Outcome validated F4 priority assignment. Patient was transferred without incident. Dialysis was performed as scheduled.

Learning Points:
1. F4 classification appropriate for routine transfers of stable patients
2. Pre-transfer assessment essential to confirm patient stability
3. Coordination with receiving facility ensures timely and efficient transfer

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller This is Guðrún from the Vestmannaeyjar clinic. We need a routine transfer for a dialysis patient.

Dispatcher Okay, can you provide the patient's name and social security number?

Caller Yes, it's Jón Einarsson, kennitala ******-****.

Dispatcher And what is the reason for the transfer?

Caller He needs to go to Landspítali for his scheduled dialysis today at 16:00.

Dispatcher Is the patient stable?

Caller Yes, he's stable and ambulatory. No acute issues.

Dispatcher Okay, I'll schedule a routine transfer. What is your location?

Caller We are at Miðgarður 2, in Vestmannaeyjar. It's the local medical clinic.

Dispatcher Alright, a transfer will be arranged. Please ensure he has all his documents. Is there a specific time you need him picked up?

Caller Anytime before 15:00 would be great to ensure he arrives in time for his dialysis. Thank you.

Dispatcher Okay, we will arrange for transport, you will be contacted with a more specific time. Thank you.