Emergency Scenario 600_f1

Location Information

Full Location:

Hafnarstræti 97, 600 Akureyri. A two-story commercial building with a storefront on the ground floor and office space on the second floor. Built in 1955, concrete and wood construction. Main entrance on Hafnarstræti, secondary entrance on the side street. No elevator, only a single interior stairwell. Street parking available. Current conditions: 8°C, clear skies, good visibility. GPS coordinates: 65.6834° N, 18.0922° W. Nearest landmark: Akureyri Art Museum.

Municipality: Akureyri

Postal Code: 600

Emergency Details

Type: Major Trauma

Priority Level: F1

Response Time Goal: Immediate (0-15 minutes)

Description:

45-year-old male, involved in a major motor vehicle accident. Primary symptoms: Unresponsive, severe head trauma, open fracture of left femur, possible internal bleeding. Secondary symptoms: Agonal breathing, pale and clammy skin, rapid and weak pulse. Patient found in vehicle, driver's side. Vehicle severely damaged. Multiple casualties at the scene. Medical history: No known allergies, no known medical conditions, no regular medications. Last meal unknown. Patient was driving alone.

History of Events

Timeline:
14:05 hours: Vehicle reported to be traveling at high speed, lost control, and collided with a building.
14:06 hours: Bystander called emergency services. Multiple casualties reported.
14:07 hours: First responders arrived on scene. Patient found unresponsive in the vehicle.
14:08 hours: Assessment of patient reveals severe injuries.
14:09 hours: Current time, patient is unresponsive, agonal breathing, awaiting advanced medical care.

Prior Events: No prior reported incidents. Patient was seen leaving a local restaurant 30 minutes prior to the accident. No witnesses to the cause of the accident. Weather conditions were clear and dry.

Diagnostics

Initial Assessment

Initial Impression: Severe Multi-System Trauma, Unresponsive
Justification for F1 Classification:
- Unresponsive patient with severe head trauma and open femur fracture, indicating life-threatening injuries.
- Agonal breathing and signs of shock (pale, clammy skin, weak pulse) indicate immediate threat to life.
- Mechanism of injury (high-speed vehicle accident) suggests high potential for internal injuries.
- Time-critical condition requiring immediate advanced life support and rapid transport to a trauma center.

Differential Diagnoses:
1. Traumatic Brain Injury (high probability)
2. Hemorrhagic Shock (high probability)
3. Open Femur Fracture (confirmed)
4. Internal Organ Damage (suspected)
5. Spinal Cord Injury (possible)

Required Actions:
- Dispatch of multiple ground EMS units with ALS capabilities.
- Dispatch of helicopter transport (if available).
- Immediate initiation of advanced life support protocols.
- Rapid extrication from vehicle.
- Preparation for immediate transport to a trauma center.

Final Diagnosis

Final Diagnosis: Severe Traumatic Brain Injury (Diffuse Axonal Injury), Hemorrhagic Shock, Open Left Femur Fracture, Multiple Rib Fractures, and Splenic Rupture
Key Findings:
- CT scan revealed diffuse axonal injury, skull fracture, and multiple rib fractures.
- Ultrasound confirmed splenic rupture and internal bleeding.
- Patient required immediate surgical intervention and blood transfusions.
- Patient was placed in induced coma for neuroprotection.

Outcome validated F1 priority assignment. Rapid dispatch, immediate life support, and rapid transport were crucial. Patient survived the initial critical period, but long-term prognosis is guarded due to severity of brain injury.

Learning Points:
1. F1 classification was essential due to the life-threatening nature of the injuries.
2. Initial assessment accurately identified the severity of the trauma.
3. Rapid transport and advanced medical intervention significantly improved the patient's chance of survival, though long term prognosis is still uncertain.

Emergency Call Transcript

Dispatcher Emergency services, what is your emergency?

Caller There's been a terrible car accident! It's at Hafnarstræti 97 in Akureyri. The car hit the building!

Dispatcher Okay, is anyone injured? How many vehicles are involved?

Caller Yes, the car is wrecked! I think there are multiple people hurt. One person in the car is not moving. It looks very bad.

Dispatcher Okay, I am sending emergency services now. Can you tell me if the person in the car is awake?

Caller No, they are not moving. I don't think they are breathing right. It sounds like gasping. There's blood, everywhere. I can see a bone sticking out of their leg.

Dispatcher Okay, stay on the line. Do not approach the vehicle, stay at a safe distance. Help is on its way. Are there any other cars involved?

Caller No, it's just one car. It's really bad. The car is crushed against the building. Please hurry!

Dispatcher Help is on the way. Stay on the line and I will guide you. Please keep the area clear for the emergency vehicles. Do you see any other injured people?

Caller I think there are some people around who might be hurt, but the person in the car looks the worst. I can hear sirens now. They're almost here.