Emergency Scenario 700_f1

Location Information

Full Location:

Miðvangur 10, 700 Egilsstaðir, single-story detached house built in 1985. Main entrance at the front of the house. No steps at the entrance. Driveway access. Weather conditions: 8°C, overcast, light wind. GPS coordinates: 65.2658° N, 14.3949° W. Nearest landmark: Egilsstaðir Airport.

Municipality: Egilsstaðir

Postal Code: 700

Emergency Details

Type: Stroke Symptoms

Priority Level: F1

Response Time Goal: Immediate (0-15 minutes)

Description:

72-year-old male, sudden onset of stroke symptoms. Primary symptoms: Right-sided facial droop, slurred speech, weakness in right arm and leg. Patient is conscious but confused. Secondary symptoms: Mild headache, dizziness. Patient was found by his wife in the living room. Medical history: Hypertension, type 2 diabetes. Medications: Metformin 1000mg twice daily, Lisinopril 20mg daily, Atorvastatin 20mg daily. No known allergies. Last meal was lunch at 13:00.

History of Events

Timeline:
15:15 hours: Patient was watching TV, appeared normal
15:20 hours: Wife noticed patient's speech was slurred, face drooping on the right side, right arm and leg weak
15:22 hours: Wife called emergency services
15:25 hours: Current time, patient remains confused, symptoms persist

Prior Events: Patient has been generally healthy, no recent illnesses or injuries. Last medical check-up 6 months ago, routine follow-up. Patient lives with his wife.

Diagnostics

Initial Assessment

Initial Impression: Suspected Acute Stroke (Cerebrovascular Accident)
Justification for F1 Classification:
- Rapid onset of focal neurological deficits (facial droop, slurred speech, hemiparesis)
- High probability of acute ischemic stroke requiring immediate intervention (thrombolysis)
- Time-critical condition; every minute of delay increases the risk of irreversible brain damage

Differential Diagnoses:
1. Ischemic Stroke (most likely)
2. Hemorrhagic Stroke (less likely, but cannot be excluded without imaging)
3. Transient Ischemic Attack (TIA) (less likely due to persistent symptoms)
4. Hypoglycemia (less likely, patient is diabetic but has eaten recently)

Required Actions:
- Immediate dispatch of ALS ground ambulance
- Pre-hospital stroke assessment (FAST exam)
- Early notification of receiving hospital (stroke center)
- Preparation for potential thrombolysis

Final Diagnosis

Final Diagnosis: Acute Ischemic Stroke (Left Middle Cerebral Artery)
Key Findings:
- CT scan confirmed an acute ischemic stroke in the left middle cerebral artery territory
- Patient's NIHSS score was 12, indicating moderate severity
- Patient was eligible for and received intravenous thrombolysis within 3 hours of symptom onset

Outcome validated F1 priority assignment. Rapid dispatch and pre-hospital notification were critical. Patient showed improvement in neurological deficits following thrombolysis.

Learning Points:
1. F1 classification was essential for timely intervention
2. Initial assessment accurately identified the high likelihood of stroke
3. Early activation of stroke protocols significantly improved patient outcome

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller My husband, I think he's having a stroke! He can't talk properly, his face is drooping!

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

Caller It's Miðvangur 10 in Egilsstaðir.

Dispatcher Help is on its way. Can you tell me what happened?

Caller He was watching TV, and then suddenly his face started drooping, and he can't speak clearly. His right arm and leg are weak, he can't move them well.

Dispatcher Is he awake and talking to you?

Caller Yes, he's awake but confused. He doesn't understand me properly.

Dispatcher Does he have any medical conditions?

Caller Yes, he has high blood pressure and diabetes. He takes medication for both.

Dispatcher Okay, the ambulance is on its way. Don't try to move him. Stay with him and keep him calm. We need to get him to the hospital as quickly as possible.

Caller Okay, thank you. I will wait here with him.