Emergency Scenario 600_f1

Location Information

Full Location:

Hafnarstræti 96, 600 Akureyri, ground floor, in the living room. It's a two-story wooden building built in 1950. Main entrance is on the street level with a small step. There is no elevator. Street parking available. The building has a basic fire alarm system. Current conditions: 7°C, clear skies, good visibility. GPS coordinates: 65.6825° N, 18.0915° W. Nearest landmark: Akureyri Art Museum.

Municipality: Akureyri

Postal Code: 600

Emergency Details

Type: Cardiac Arrest

Priority Level: F1

Response Time Goal: Immediate (0-15 minutes)

Description:

68-year-old male found unresponsive by his son. Primary symptom: Unresponsive, not breathing, no pulse. Secondary symptoms: Patient is pale and clammy. Patient is lying on the floor in the living room. Medical history: History of coronary artery disease, previous myocardial infarction, hypertension. Medications: Aspirin 75mg daily, Metoprolol 50mg daily, Atorvastatin 20mg daily. No known allergies. Last meal was a light lunch at 13:00.

History of Events

Timeline:
1430 hours: Patient was watching TV, appeared normal.
1445 hours: Son found patient unresponsive on the floor.
1446 hours: Son called emergency services.
1447 hours: Current time, patient still unresponsive, not breathing.

Prior Events: Patient has a history of heart problems, including a heart attack five years ago. He has been regularly monitored by a cardiologist. Last check-up was three months ago, with no significant changes reported. He has been complaining of mild chest discomfort for the past week, but attributed it to indigestion.

Diagnostics

Initial Assessment

Initial Impression: Cardiac Arrest
Justification for F1 Classification:
- Patient is unresponsive, not breathing, and pulseless
- This is a life-threatening emergency requiring immediate intervention
- Time-critical condition with high risk of irreversible damage if not treated promptly

Differential Diagnoses:
1. Cardiac Arrest (most likely)
2. Respiratory Arrest (less likely given history)
3. Massive Stroke (less likely given sudden onset)
4. Hypoglycemia (less likely given no history of diabetes)

Required Actions:
- Immediate dispatch of ground EMS with ALS capabilities
- Dispatch of a second ambulance for backup
- Early notification to the receiving hospital for cardiac team activation
- Initiate CPR instructions to caller

Final Diagnosis

Final Diagnosis: Ventricular Fibrillation leading to Cardiac Arrest
Key Findings:
- ECG confirmed ventricular fibrillation as the cause of arrest
- Successful defibrillation restored a perfusing rhythm
- Patient was subsequently intubated and transported to the hospital

Outcome validated F1 priority assignment. Rapid dispatch and early CPR were critical. Patient underwent coronary angiography and stenting. 

Learning Points:
1. F1 classification was essential for timely intervention.
2. Dispatcher-guided CPR was vital in maintaining perfusion until EMS arrival.
3. Early recognition of cardiac arrest symptoms is critical for optimal patient outcomes.

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller My father! I think he's dead! He's not breathing!

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

Caller It's Hafnarstræti 96, ground floor in Akureyri.

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

Caller I found him on the floor. He's not moving and he's not breathing! He was just watching TV a few minutes ago.

Dispatcher Is he awake? Can he talk to you?

Caller No! He's completely unresponsive! I can't feel him breathing! Oh my god!

Dispatcher Okay, stay calm. I'm going to help you. Is he on his back?

Caller Yes, he's on his back on the living room floor.

Dispatcher Okay, I need you to start chest compressions. Put the heel of one hand on the center of his chest, and the other hand on top. Push hard and fast.

Caller Okay, okay, I'm doing it. Is that right?

Dispatcher Yes, keep going, hard and fast. We are on our way. Do you know if he has any medical conditions?

Caller Yes, he has heart problems, he had a heart attack before. He takes medications for it. I think it was aspirin and something for his blood pressure.

Dispatcher Okay, keep doing the compressions, help is almost there. Don't stop.

Caller I'm trying...it's hard...please hurry!