Emergency Scenario 700_f1

Location Information

Full Location:

Miðgarður 17, 700 Egilsstaðir, detached single-story residential house built in 1985. Main entrance via front door, no other access points. No security features present. Flat terrain, gravel driveway. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.2667° N, 14.3967° W. Nearest landmark: Egilsstaðir Swimming Pool.

Municipality: Egilsstaðir

Postal Code: 700

Emergency Details

Type: Major Trauma

Priority Level: F1

Response Time Goal: Immediate (0-15 minutes)

Description:

45-year-old male, involved in a high-speed motorcycle accident. Primary symptoms: Unresponsive, severe head trauma, multiple visible fractures, profuse bleeding from head and leg. Secondary symptoms: Agonal respirations, weak and rapid pulse. Patient found lying on the road, motorcycle severely damaged nearby. Medical history: No known medical conditions, no allergies. No medications. Last meal unknown. Events: Motorcycle crash 5 minutes ago.

History of Events

Timeline:
0 minutes: Motorcycle crash, witness reports high speed impact with guardrail.
0-1 minutes: Witness attempts to rouse the patient, finds him unresponsive, begins call to emergency services.
1-2 minutes: Caller provides initial information to dispatcher, confirming unresponsiveness and severe injuries.
2-3 minutes: Dispatcher confirms F1 priority and initiates immediate dispatch of ground and air ambulance.
3-5 minutes: Current time, patient remains unresponsive, agonal respirations, profuse bleeding. No interventions attempted by bystanders.
Prior Events: None reported. Patient was seen wearing full protective gear, but impact was severe.

Diagnostics

Initial Assessment

Initial Impression: Severe Traumatic Brain Injury with Polytrauma
Justification for F1 Classification:
- Unresponsiveness, severe head trauma, and multiple visible fractures indicate a life-threatening condition requiring immediate intervention.
- Agonal respirations and profuse bleeding suggest imminent respiratory and circulatory compromise.
- Time-critical condition requiring rapid transport to a trauma center.

Differential Diagnoses:
1. Traumatic Brain Injury (TBI) with skull fracture and possible intracranial hemorrhage (highest probability).
2. Multiple long bone fractures (femur, tibia, fibula).
3. Internal hemorrhage (abdominal, thoracic).
4. Spinal cord injury (potential given mechanism of injury).
5. Tension pneumothorax (potential given chest trauma).

Required Actions:
- Immediate dispatch of ground and air ambulance with ALS capabilities.
- Notification of trauma center for potential transfer.
- Rapid sequence intubation (RSI) and ventilation as needed.
- Hemorrhage control.
- Spinal precautions.
- IV access and fluid resuscitation.

Final Diagnosis

Final Diagnosis: Severe Traumatic Brain Injury (Diffuse Axonal Injury) with Multiple Fractures
Key Findings:
- CT scan confirmed diffuse axonal injury, multiple skull fractures, and subarachnoid hemorrhage.
- X-rays revealed fractures of the right femur, tibia, and fibula.
- Patient required emergency craniotomy and orthopedic surgery.
- Patient was placed on a ventilator and admitted to ICU.

Outcome validated F1 priority assignment. Immediate dispatch and rapid interventions were critical. Patient's condition remained critical despite all interventions.

Learning Points:
1. F1 classification was essential given the severity of injuries and the need for immediate life-saving interventions.
2. Initial assessment accurately identified the high likelihood of severe TBI and multiple fractures.
3. Rapid transport to a trauma center was crucial for the patient's survival, despite poor overall prognosis.

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller There's been a terrible motorcycle accident! On Miðgarður, near the swimming pool! The guy is really hurt!

Dispatcher Okay, I'm sending help immediately. What happened exactly?

Caller He crashed into the guardrail! He was going so fast! He's not moving! He's bleeding really badly from his head!

Dispatcher Is he awake? Is he breathing?

Caller No, he's not awake! He's making weird noises and gasping for air! There's so much blood!

Dispatcher Okay, help is on its way. Do not move him. Are there any other injuries you can see?

Caller His leg looks broken too, it's bent in a funny way. Oh god, there is so much blood! I think he is dying!

Dispatcher Okay, stay calm. The ambulance is on its way. Do not move him and stay on the line with me if you can.

Caller Okay, okay I will stay here... I am scared... please hurry!