Emergency Scenario 700_f1

Location Information

Full Location:

Miðgarður 11, 700 Egilsstaðir, detached single-family home. One story wooden structure built in 1995. Main entrance at front, no security features. Driveway access. Current conditions: 8°C, clear skies, good visibility. GPS coordinates: 65.2668° N, 14.3937° W. Nearest landmark: Egilsstaðir Swimming Pool.

Municipality: Egilsstaðir

Postal Code: 700

Emergency Details

Type: Cardiac Arrest

Priority Level: F1

Response Time Goal: Immediate (0-15 minutes)

Description:

68-year-old male, found unresponsive. Primary symptoms: Unresponsive, not breathing, no pulse. Secondary symptoms: Cyanosis around lips. Patient found on living room floor. Medical history: Coronary artery disease, previous myocardial infarction (MI) 5 years ago, hypertension, type 2 diabetes. Medications: Metoprolol 50mg BID, Aspirin 75mg daily, Atorvastatin 20mg daily, Metformin 1000mg BID. Known allergy to penicillin. Last meal was a light lunch at 13:00.

History of Events

Timeline:
1400 hours: Patient was watching TV, reported feeling unwell, complained of chest pain.
1405 hours: Patient became unresponsive, collapsed to the floor.
1406 hours: Caller, the patient's son, found him, initiated CPR.
1407 hours: Caller dialed emergency services.
1408 hours: Current time, CPR in progress, patient unresponsive.

Prior Events: Patient had a routine check-up 6 months ago, with no significant changes noted. No recent illnesses or injuries. Patient has a history of non-compliance with dietary recommendations. No known recent changes in medication.

Diagnostics

Initial Assessment

Initial Impression: Cardiac Arrest
Justification for F1 Classification:
- Patient is unresponsive, not breathing, and pulseless, indicating a life-threatening condition.
- Time-critical intervention is required to maximize chances of survival.
- High probability of cardiac etiology given history of CAD and prior MI.

Differential Diagnoses:
1. Cardiac Arrest (most likely)
2. Severe Hypoglycemia (less likely given history of diabetes, no history of insulin use)
3. Massive Pulmonary Embolism (less likely, no prior history)
4. Stroke (less likely, no focal neurological deficits reported prior to collapse)

Required Actions:
- Dispatch of ground EMS with ALS capabilities and AED
- Immediate CPR instructions to caller
- Early notification of hospital for possible cardiac catheterization lab activation
- Rapid transport to nearest hospital with cardiac care facilities

Final Diagnosis

Final Diagnosis: Ventricular Fibrillation Leading to Cardiac Arrest
Key Findings:
- ECG on arrival showed ventricular fibrillation
- Defibrillation was successful in restoring a perfusing rhythm
- ROSC achieved after one shock and further ALS interventions
- Subsequent blood work and cardiac enzymes confirmed an acute MI.

Outcome validated F1 priority assignment. Immediate CPR by the caller and rapid defibrillation by the paramedics were critical to patient survival.

Learning Points:
1. Early recognition of cardiac arrest and immediate initiation of CPR are paramount.
2. F1 classification was appropriate and critical to ensure rapid response.
3. Caller education and support in CPR performance can improve patient outcomes.

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller My father! He's not breathing! He just collapsed!

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

Caller It's Miðgarður 11 in Egilsstaðir.

Dispatcher Help is on its way. Is he conscious?

Caller No! He's completely unresponsive. I can't feel a pulse and he is not breathing. I think he is dead!

Dispatcher Okay, I need you to start chest compressions right away. Do you know how to do CPR?

Caller I... I think so, I took a class a long time ago... Okay, I will start pushing on his chest.

Dispatcher That's good, keep pushing hard and fast in the center of his chest. The ambulance is on its way. Can you tell me his medical history?

Caller He has heart problems and diabetes. He had a heart attack before. He takes medication for it.

Dispatcher Okay, keep doing the chest compressions. Do not stop until the ambulance arrives. We are almost there.

Caller Okay, I'm doing it, I'm doing it, but he's not waking up! I'm so scared!