Emergency Scenario 600_f1

Location Information

Full Location:

Hlíðarvegur 14, 600 Akureyri. Single-family detached home, two stories, built in 1985, wooden construction with a concrete foundation. Main entrance on the north side, accessible by a short walkway. Driveway access on the west side. No known security systems or access codes. Current weather conditions: 3°C, overcast, light snow, moderate visibility. Road conditions: icy patches, caution advised. GPS coordinates: 65.6789° N, 18.0823° W. Nearest landmark: Glerárkirkja church.

Municipality: Akureyri

Postal Code: 600

Emergency Details

Type: Major Trauma

Priority Level: F1

Response Time Goal: Immediate (0-15 minutes)

Description:

35-year-old male, involved in a severe motor vehicle accident. Primary symptoms: Unresponsive, labored breathing, visible head trauma with active bleeding, deformed left leg, suspected internal injuries. Secondary symptoms: None reported by caller due to patient's unresponsiveness. Patient found in a severely damaged vehicle. Airbag deployed. Medical history unknown. No known allergies or medications. Last oral intake unknown. Patient trapped in vehicle.

History of Events

Timeline:
10:00 hours: Vehicle accident occurred, single vehicle collision into a light pole.
10:01 hours: Bystander called emergency services, reporting a major accident with severe injuries.
10:02 hours: Current time, patient is still trapped in vehicle, unresponsive. Heavy damage to the front of the vehicle. Bystander reports no movement from the patient since the accident.

Diagnostics

Initial Assessment

Initial Impression: Critical Trauma Patient (F1)
Justification for F1 Classification:
- Unresponsive patient with suspected head trauma and internal injuries.
- Labored breathing indicates respiratory compromise.
- Major mechanism of injury (high-speed motor vehicle accident) increases the likelihood of severe, life-threatening injuries.
- Time-critical condition requiring immediate advanced life support intervention.

Differential Diagnoses:
1. Traumatic Brain Injury (TBI) with possible intracranial hemorrhage
2. Hemothorax/Pneumothorax
3. Abdominal Trauma with internal bleeding
4. Multiple Fractures (including pelvic and long bones)
5. Spinal Cord Injury (high suspicion due to mechanism)

Required Actions:
- Immediate dispatch of ground EMS with ALS capabilities.
- Dispatch of fire and rescue services for vehicle extrication.
- Helicopter activation pending scene assessment.
- Notification of trauma center at Akureyri Hospital for immediate surgical team standby.

Final Diagnosis

Final Diagnosis: Severe Traumatic Brain Injury (Diffuse Axonal Injury), Hemopneumothorax, Left Femur Fracture, Pelvic Fracture
Key Findings:
- CT scan revealed diffuse axonal injury with significant cerebral edema.
- Chest X-ray confirmed hemopneumothorax on the left side.
- Left femur fracture and pelvic fracture were identified on X-ray.
- Patient required immediate intubation and mechanical ventilation.
- Patient underwent emergency chest tube insertion and pelvic stabilization.

Outcome validated F1 priority assignment. Immediate dispatch and rapid intervention were critical. Patient was transferred to ICU for ongoing care. Prognosis is guarded.

Learning Points:
1. F1 classification was essential due to the severity of injuries and the patient's critical condition.
2. Initial assessment accurately identified the life-threatening nature of the event.
3. The need for rapid extrication, advanced life support, and trauma center transfer was crucial for patient survival.

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller There's been a terrible accident! A car has crashed into a light pole, it's really bad!

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

Caller It's on Hlíðarvegur 14 in Akureyri, near the church. The car is completely wrecked!

Dispatcher Help is on its way. Is anyone injured?

Caller Yes, the driver is still inside, he's not moving! I don't think he's breathing properly. There's blood, and his leg looks broken!

Dispatcher Is he conscious? Can you talk to him?

Caller No, he's not responding at all! He's just... lying there. The car is a mess.

Dispatcher Okay, stay on the line. Do you see any other cars or people involved?

Caller No, it's just this one car. The airbag is deployed, and there's a lot of damage. I think he's trapped.

Dispatcher Okay, fire and rescue are being dispatched along with the ambulance. Do not attempt to move him. Stay back from the vehicle and wait for help to arrive.

Caller Okay, I understand. I'll stay back and wait.