Emergency Scenario 700_f1

Location Information

Full Location:

Miðgarður 2, 700 Egilsstaðir, single-story detached house. Built in 1985. Main entrance is on the south side with a ramp. No known security features. Surrounded by a small garden. Current conditions: 8°C, overcast, light wind. GPS coordinates: 65.2655° N, 14.3959° W. Nearest landmark: Egilsstaðir Swimming Pool.

Municipality: Egilsstaðir

Postal Code: 700

Emergency Details

Type: Sepsis

Priority Level: F1

Response Time Goal: Immediate (0-15 minutes)

Description:

78-year-old male, exhibiting signs of severe sepsis. Primary symptoms: High fever (39.5°C), rapid heart rate (120 bpm), rapid and shallow breathing (28 breaths per minute), confusion, and lethargy. Secondary symptoms: Shivering, pale skin, and reports of generalized weakness. Patient is lying in bed. History of urinary tract infection treated with antibiotics 3 days ago. Patient is diabetic and has a history of heart disease.

History of Events

Timeline:
0800 hours: Patient woke up feeling unwell, with shivering and fatigue.
0900 hours: Patient developed a fever and started feeling confused.
1000 hours: Patient's condition worsened, with rapid breathing and increased lethargy.
1030 hours: Caller, patient's daughter, found him unresponsive and called emergency services.
1032 hours: Current time, patient is unresponsive and showing signs of severe illness.

Prior Events: Patient had a diagnosed UTI 3 days prior and was prescribed antibiotics. Patient has a history of Type 2 diabetes, managed with oral medication. Patient has a history of coronary artery disease and had a stent placed 5 years ago. No known allergies. Last meal was light breakfast at 07:00.

Diagnostics

Initial Assessment

Initial Impression: Severe Sepsis Secondary to UTI
Justification for F1 Classification:
- Patient presents with multiple signs of severe sepsis, including fever, tachycardia, tachypnea, and altered mental status.
- High risk of rapid deterioration and multi-organ failure.
- Time-critical condition requiring immediate medical intervention.

Differential Diagnoses:
1. Sepsis (most likely)
2. Septic Shock (highly probable given the severity)
3. Severe Dehydration (less likely given fever and other signs)
4. Acute Myocardial Infarction (less likely given primary symptoms)

Required Actions:
- Immediate dispatch of ground EMS with ALS capabilities
- Early hospital notification of a potential sepsis case
- Initiate sepsis protocols (IV access, fluid resuscitation, oxygen administration)
- Preparation for rapid transport to nearest hospital with ICU capabilities

Final Diagnosis

Final Diagnosis: Septic Shock Secondary to Urosepsis
Key Findings:
- Blood cultures confirmed a gram-negative bacterial infection consistent with urosepsis.
- Patient's lactate levels were significantly elevated, indicating severe tissue hypoperfusion.
- Patient required vasopressor support to maintain blood pressure in the ICU.

Outcome validated F1 priority assignment. Rapid dispatch and early treatment were crucial for survival. Patient was stabilized in the ICU after aggressive fluid resuscitation and antibiotic therapy.

Learning Points:
1. F1 classification appropriate due to the critical nature of sepsis and the need for immediate intervention.
2. Initial assessment accurately identified the high likelihood of sepsis based on the combination of symptoms.
3. Early recognition of sepsis and prompt initiation of treatment are critical for improving patient outcomes.

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller My father is very sick! I think he is dying!

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

Caller It's Miðgarður 2 in Egilsstaðir. Please hurry!

Dispatcher Help is on its way. Can you tell me what's happening?

Caller He's burning up, he's confused, and he is breathing really fast. He was sick before with a bladder infection, but now it's so much worse!

Dispatcher Is he awake and talking to you now?

Caller He is not really talking, he is just lying there. He's not responding very well. I'm scared!

Dispatcher Does he have any medical conditions?

Caller He has diabetes and a heart condition. He just finished antibiotics for a bladder infection a few days ago. Oh god, please hurry!

Dispatcher Okay, the ambulance is on its way. Don't try to move him. Stay with him and try to keep him calm. Help is coming!

Caller Okay, thank you. I'm so worried.