Emergency Scenario 600_f1

Location Information

Full Location:

Hlíðarvegur 2, 600 Akureyri. Single-family detached home, built in 1995. Two stories, wooden frame construction with concrete foundation. Main entrance via front door, secondary entrance at the rear. No security system. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6754° N, 18.0826° W. Nearest landmark: Glerárskóli School.

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 motorcycle accident. Primary symptoms: Unresponsive, significant head trauma, obvious deformity of left leg, labored breathing. Secondary symptoms: Multiple abrasions and lacerations, possible internal bleeding. Patient found lying on the side of the road next to his motorcycle. Scene is partially obscured by a small embankment. Medical history: No known allergies, no significant medical history, no regular medications. Last meal unknown, approximately 3 hours ago. Events: Patient was riding his motorcycle when he lost control on a curve.

History of Events

Timeline:
14:10 hours: Patient was riding his motorcycle on Hlíðarvegur.
14:12 hours: Patient lost control of motorcycle on a curve, veered off road, and crashed into a small embankment.
14:13 hours: Bystander (caller) discovered the patient lying unresponsive next to his motorcycle.
14:14 hours: Bystander calls emergency services.
14:15 hours: Current time, patient unresponsive, labored breathing, obvious injuries.

Diagnostics

Initial Assessment

Initial Impression: Severe Traumatic Injury - Head Trauma, Suspected Multiple Fractures, Possible Internal Bleeding
Justification for F1 Classification:
- Unresponsive patient with significant mechanism of injury (high-speed motorcycle crash)
- Presence of head trauma, labored breathing, and obvious extremity deformity indicate life-threatening condition
- High risk of rapid deterioration, necessitating immediate medical intervention

Differential Diagnoses:
1. Traumatic Brain Injury (high probability)
2. Hemorrhagic Shock (high probability due to mechanism and injuries)
3. Multiple Fractures (high probability given impact)
4. Pneumothorax/Hemothorax (possible due to chest trauma)
5. Spinal Cord Injury (possible, must be considered)

Required Actions:
- Immediate dispatch of ALS ground ambulance and air ambulance if available
- Pre-notification of trauma center for activation
- Initiate airway management, oxygenation, and ventilation support
- Control hemorrhage and initiate fluid resuscitation
- Spinal immobilization and rapid transport to hospital

Final Diagnosis

Final Diagnosis: Severe Traumatic Brain Injury with Subdural Hematoma, Left Femur Fracture, Multiple Rib Fractures, Hemopneumothorax
Key Findings:
- CT scan revealed a large subdural hematoma with midline shift, indicating severe brain injury
- X-ray confirmed a comminuted fracture of the left femur and multiple rib fractures
- Chest x-ray and CT showed hemopneumothorax requiring chest tube insertion
- Patient's GCS score was 3 on arrival at the hospital
- Significant internal bleeding was confirmed, requiring immediate blood transfusion

Outcome validated F1 priority assignment. Immediate ALS intervention, rapid transport, and trauma center activation were critical for survival. Patient required neurosurgical intervention and prolonged ICU care.

Learning Points:
1. F1 classification was essential for timely response and life-saving interventions
2. Initial assessment accurately identified the severity of the injuries and potential for rapid deterioration
3. Mechanism of injury (high-speed motorcycle crash) is a strong predictor of severe trauma and should trigger immediate F1 response

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller I need an ambulance! There's been a motorcycle accident on Hlíðarvegur. The guy is badly hurt!

Dispatcher Okay, I'm sending help. Can you give me the exact location?

Caller It's on Hlíðarvegur 2, near Glerárskóli School. He's off the road, by the embankment.

Dispatcher Help is on its way. Is he conscious?

Caller No, he's not responding. He's breathing, but it's really labored. He has a bad head injury and his leg looks broken.

Dispatcher Okay, is there any bleeding?

Caller Yes, there's a lot of blood. I don't know where it's all coming from. He's in really bad shape.

Dispatcher Stay where you are and do not attempt to move him. Help is on the way. Do you see any other dangers?

Caller No, I don't see anything else dangerous. Just the bike and the guy.

Dispatcher Okay, please stay on the line until the ambulance arrives.