Emergency Scenario 465_f1

Location Information

Full Location:

Hafnargata 17, 465 Bíldudalur, a single-story wooden house built in 1965. Main entrance is on the south side, no stairs. No security features. Gravel driveway. Current conditions: 8°C, overcast, light wind, good visibility. GPS coordinates: 65.7167° N, 23.5333° W. Nearest landmark: Bíldudalur harbor.

Municipality: Bíldudalur

Postal Code: 465

Emergency Details

Type: Sepsis

Priority Level: F1

Response Time Goal: Immediate (0-15 minutes)

Description:

65-year-old female, suspected sepsis. Primary symptoms: High fever (39.5°C), chills, rapid heart rate (120 bpm), rapid breathing (28 breaths/min), confusion, and lethargy. Patient appears very ill and weak. Secondary symptoms: Patient reports feeling unwell for the past 2 days with increasing fatigue and muscle aches. Skin is pale and clammy. Patient is currently lying in bed. Medical history: Type 2 diabetes, recent urinary tract infection treated with antibiotics 1 week ago. Medications: Metformin 1000mg twice daily, Amoxicillin 500mg three times daily (finished course 3 days ago). Allergies: Penicillin. Last meal was a light soup at 18:00 yesterday.

History of Events

Timeline:
Day 1: Patient reports feeling generally unwell, mild fatigue and muscle aches.
Day 2: Symptoms worsen, patient develops fever, chills, and increased weakness. Patient is confused.
0800 hours: Patient's daughter checks on her, finds her confused and with a high fever.
0810 hours: Daughter calls emergency services.
0812 hours: Current time, patient is still in bed, lethargic and confused.

Diagnostics

Initial Assessment

Initial Impression: Suspected Sepsis secondary to recent UTI.
Justification for F1 Classification:
- Presence of multiple systemic inflammatory response syndrome (SIRS) criteria: fever, tachycardia, tachypnea, altered mental status.
- Patient has a recent history of UTI and antibiotic use, increasing the risk of sepsis.
- Rapidly deteriorating condition with confusion and lethargy.
- Time-critical condition requiring immediate medical intervention.

Differential Diagnoses:
1. Sepsis (high probability)
2. Severe UTI (less likely given systemic symptoms)
3. Pneumonia (possible but less likely given lack of respiratory symptoms)
4. Diabetic Ketoacidosis (possible but less likely given lack of classic symptoms)

Required Actions:
- Immediate dispatch of ground EMS with ALS capabilities.
- Pre-notification of hospital emergency department.
- Initiation of sepsis protocol, including IV access, fluid resuscitation, and oxygen administration.
- Continuous monitoring of vital signs and level of consciousness.

Final Diagnosis

Final Diagnosis: Severe Sepsis secondary to Urosepsis.
Key Findings:
- Blood cultures confirmed gram-negative bacteria, indicating a urosepsis.
- Patient's lactate level was elevated, confirming severe sepsis.
- Patient responded to IV fluids and antibiotics, but required intensive care.
- Initial assessment accurately identified the high likelihood of sepsis.

Outcome validated F1 priority assignment. Rapid dispatch and early sepsis management were critical for patient survival. Patient required several days of intensive care but ultimately recovered.

Learning Points:
1. F1 classification appropriate due to the need for immediate intervention.
2. Dispatch information and symptoms were highly suggestive of sepsis.
3. Rapid recognition of sepsis and initiation of treatment protocols are critical for improving outcomes.

Emergency Call Transcript

Dispatcher Emergency services, what is your emergency?

Caller My mother is very sick! She has a high fever and is confused.

Dispatcher Okay, I'm sending help. What is your address?

Caller It's Hafnargata 17 in Bíldudalur.

Dispatcher Help is on its way. Can you tell me what happened?

Caller She's been feeling unwell for two days, but today she's much worse. She has a very high fever and is acting confused. She's very weak.

Dispatcher Is she awake and talking to you?

Caller Yes, but she's very confused. She's mostly just lying in bed. She feels hot and is shivering.

Dispatcher Does she have any medical conditions?

Caller Yes, she has diabetes. And she had a urinary infection last week, she finished her antibiotics a few days ago.

Dispatcher Okay, the ambulance is on its way. Don't try to move her. Stay with her and keep her calm. Do you know if she has any allergies?

Caller Yes, she is allergic to penicillin. I will stay with her, thank you.