Emergency Scenario 600_f1

Location Information

Full Location:

Hlíðarvegur 14, 600 Akureyri, single-family home. Two-story wooden structure, built in 1985. Main entrance has a single wooden door. No elevator. Outdoor stairs to front door. Parking available in driveway. No known security features. Current conditions: 7°C, clear skies, good visibility. GPS coordinates: 65.6779° N, 18.0852° 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:

45-year-old male, involved in a serious motor vehicle accident. Primary symptoms: Unresponsive, severe head trauma, visible open fracture of the left femur, significant bleeding. Secondary symptoms: Labored breathing, possible chest trauma, obvious deformity of left arm. Patient found outside of vehicle, approximately 5 meters away. Patient is not moving. Car is severely damaged. Scene is dangerous. Possible entrapment risk.

History of Events

Timeline:
14:30 hours: Patient driving on Hlíðarvegur, lost control, collided with a tree.
14:31 hours: Witnessed by a passerby who immediately called emergency services.
14:32 hours: Caller arrived at scene, found patient outside vehicle, unresponsive.
14:33 hours: Current time. Patient is still unresponsive, significant bleeding noted. No prior medical history available from caller. Caller reports no known allergies or medications for the patient. Caller reports patient was alone in the vehicle. Last oral intake unknown. Events leading to the incident are unknown.

Diagnostics

Initial Assessment

Initial Impression: Severe Multi-System Trauma with Head Injury
Justification for F1 Classification:
- Unresponsive patient with obvious signs of severe trauma including head injury, open fracture, and significant bleeding
- High risk of rapid deterioration due to potential internal injuries and airway compromise
- Time-critical situation requiring immediate advanced life support

Differential Diagnoses:
1. Traumatic Brain Injury (high probability)
2. Hemorrhagic Shock (high probability)
3. Open Femur Fracture (confirmed)
4. Chest Trauma with Possible Pneumothorax/Hemothorax (likely)
5. Internal Abdominal Injuries (possible)
6. Cervical Spine Injury (high probability)

Required Actions:
- Immediate dispatch of ground EMS with ALS capabilities and trauma team activation
- Air ambulance dispatch considered due to severity of trauma and potential transport challenges
- Scene safety assessment and securing the area
- Rapid patient extrication and stabilization
- Advanced airway management and hemorrhage control
- Early notification of the receiving trauma center

Final Diagnosis

Final Diagnosis: Severe Traumatic Brain Injury (Diffuse Axonal Injury), Open Left Femur Fracture, Left Radial Fracture, Hemopneumothorax, Grade III Liver Laceration
Key Findings:
- CT scan revealed diffuse axonal injury and subdural hematoma
- X-rays confirmed open left femur fracture and left radial fracture
- Chest X-ray and CT scan showed hemopneumothorax
- Abdominal CT revealed a Grade III liver laceration with active bleeding

Outcome validated F1 priority assignment. Immediate interventions were critical for survival. Patient required emergent surgical interventions and ICU admission.

Learning Points:
1. F1 classification was essential given the life-threatening nature of the injuries
2. Initial assessment accurately identified the severity of the trauma
3. Rapid transport and aggressive resuscitation were crucial for patient survival
4. High index of suspicion for internal injuries should always be present in high-impact trauma

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller There's been a terrible car accident! On Hlíðarvegur. The car hit a tree. Someone is badly hurt!

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

Caller It's Hlíðarvegur 14, Akureyri. The car is wrecked. The man is outside the car, he's not moving!

Dispatcher Is the patient conscious? Are they breathing?

Caller I don't think so, he's not moving at all. There's a lot of blood. I think he's hurt really bad. I can see a bone sticking out of his leg!

Dispatcher Okay, stay calm. Help is on its way. Do you know if anyone else was in the car?

Caller No, I don't think so. I only see one person. He looks really bad, please hurry!

Dispatcher We are on our way. Do not move the patient. Stay at a safe distance from the vehicle. Do you see anything else that might be dangerous?

Caller No, just the wrecked car and the man. There's a lot of debris around. I'll wait here until help arrives.