Emergency Scenario 600_f1

Location Information

Full Location:

Hlíðarvegur 14, 600 Akureyri, single-family detached home. One-story wooden structure built in 1965. Main entrance via front door with one step. No elevator. Driveway access from Hlíðarvegur. House has basic security with standard lock. Current conditions: 8°C, clear skies, good visibility. GPS coordinates: 65.6762° N, 18.0838° W. Nearest landmark: Glerárskóli school.

Municipality: Akureyri

Postal Code: 600

Emergency Details

Type: Major Trauma - Motor Vehicle Accident

Priority Level: F1

Response Time Goal: Immediate (0-15 minutes)

Description:

35-year-old male, driver of a vehicle involved in a high-speed collision with a tree. Primary symptoms: Unresponsive, significant head trauma, suspected chest trauma, obvious leg deformity. Secondary symptoms: Heavy bleeding from head wound, shallow and labored breathing. Patient is trapped in the vehicle. Medical history: No known medical conditions, no known allergies. No current medications. Last meal was lunch at 13:00. Witness reports vehicle traveling at high speed.

History of Events

Timeline:
1445 hours: Vehicle traveling at high speed veered off road and collided with a tree
1446 hours: Witness (caller) called emergency services
1447 hours: Current time, patient unresponsive and trapped in vehicle

Prior Events: No known history of reckless driving. No recent illnesses or injuries. Last medical check-up 1 year ago, routine follow-up. Patient was alone in the vehicle. No known alcohol or drug use.

Diagnostics

Initial Assessment

Initial Impression: Critical Multi-System Trauma
Justification for F1 Classification:
- Unresponsive patient with significant head and chest trauma
- High-speed collision mechanism indicates severe injuries
- Time-critical condition requiring immediate intervention and rapid transport

Differential Diagnoses:
1. Traumatic Brain Injury (high probability)
2. Tension Pneumothorax (high probability)
3. Hemothorax (high probability)
4. Spinal Cord Injury (high probability)
5. Femur Fracture (high probability)
6. Internal Bleeding (high probability)

Required Actions:
- Dispatch of ground EMS with ALS capabilities, fire department for extrication
- Pre-hospital trauma protocols initiation
- Rapid transport to nearest trauma center
- Early hospital notification for trauma team activation

Final Diagnosis

Final Diagnosis: Severe Traumatic Brain Injury (TBI), Tension Pneumothorax, Right Femur Fracture, Multiple Rib Fractures, Splenic Laceration
Key Findings:
- CT scan revealed a subdural hematoma and diffuse axonal injury
- Chest X-ray confirmed a tension pneumothorax and multiple rib fractures
- Abdominal CT showed a splenic laceration
- Right femur fracture confirmed on X-ray
- Patient underwent emergent decompressive craniectomy, chest tube insertion, and splenectomy.

Outcome validated F1 priority assignment. Rapid dispatch, extrication, and transport were critical for survival. Patient required extensive ICU care and long-term rehabilitation.

Learning Points:
1. F1 classification was essential for immediate resource allocation
2. Initial assessment accurately identified the high likelihood of severe multi-system trauma
3. Rapid extrication and transport were crucial for patient outcome

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller There's been a terrible accident! A car just crashed into a tree, very badly. It was on Hlíðarvegur, near the school.

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

Caller It's Hlíðarvegur 14, Akureyri. The car is badly damaged and the driver isn't moving.

Dispatcher Help is on its way. Is the driver conscious?

Caller No, I don't think so. He's not moving or responding. There's a lot of blood. I can't get him out of the car, it's all smashed up.

Dispatcher Okay, is the car on fire or is there any other immediate danger?

Caller No fire, but the car is really badly damaged. I don't know what to do. He's not breathing well, it's like a gasp.

Dispatcher Okay, stay where you are and keep a safe distance. Do not try to move him. Help is on its way. Is there anyone else in the vehicle?

Caller No, just the driver. I think he's badly hurt. Please hurry!

Dispatcher We are on our way. Stay on the line if you can.