Emergency Scenario 700_f1

Location Information

Full Location:

Miðgarður 1, 700 Egilsstaðir, Single-story detached house built in 1985. Main entrance facing the street, no security features. Gravel driveway with parking for two cars. The house is located in a residential area. Current conditions: 8°C, clear skies, good visibility. GPS coordinates: 65.2685° N, 14.3942° W. Nearest landmark: Egilsstaðir Airport terminal.

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 car accident. Primary symptoms: Unresponsive, severe head trauma, visible skull fracture, multiple open fractures in both legs, heavy bleeding from multiple sites. Secondary symptoms: Agonal breathing, pale and clammy skin, rapid weak pulse. Patient found outside the vehicle. No known medical history provided. No known allergies. No medications reported. Last meal was unknown. Mechanism of injury: High-speed vehicle rollover.

History of Events

Timeline:
14:00 hours: Vehicle accident occurred, high-speed rollover on Route 1 outside Egilsstaðir.
14:01 hours: Witness called emergency services, reporting unresponsive driver with severe injuries.
14:02 hours: Caller assessed the scene and reported heavy bleeding and multiple fractures.
14:03 hours: Current time, patient remains unresponsive and in critical condition.

Prior Events: No prior medical history provided by the caller. The caller is a passerby who witnessed the accident.

Diagnostics

Initial Assessment

Initial Impression: Severe Polytrauma, Traumatic Brain Injury (TBI), Hemorrhagic Shock
Justification for F1 Classification:
- Unresponsive patient with significant head trauma and multiple fractures
- High probability of life-threatening injuries and rapid deterioration
- Requires immediate medical intervention and rapid transport to trauma center

Differential Diagnoses:
1. Traumatic Brain Injury (TBI) with skull fracture (high probability)
2. Hemorrhagic Shock (high probability)
3. Multiple Open Fractures (high probability)
4. Spinal Cord Injury (high probability, must be considered)
5. Internal Organ Damage (high probability)

Required Actions:
- Dispatch of ground EMS with ALS capabilities
- Immediate dispatch of helicopter if available
- Airway management and oxygenation
- Hemorrhage control and fluid resuscitation
- Spinal immobilization
- Rapid transport to the nearest trauma center with surgical capabilities

Final Diagnosis

Final Diagnosis: Severe Traumatic Brain Injury (Diffuse Axonal Injury), Hemorrhagic Shock secondary to multiple open fractures, bilateral femur fractures, multiple rib fractures, and splenic rupture.
Key Findings:
- CT scan revealed diffuse axonal injury and multiple skull fractures.
- Severe internal bleeding from splenic rupture was confirmed via ultrasound.
- Patient required immediate surgical intervention to control hemorrhage and stabilize fractures.
- Patient remained in critical condition, requiring intensive care and mechanical ventilation.

Outcome validated F1 priority assignment. Immediate medical intervention was crucial, and the patient was transferred to a level 1 trauma center via helicopter.

Learning Points:
1. F1 classification was crucial for ensuring rapid response and transport.
2. Initial assessment accurately identified the high probability of life-threatening injuries.
3. Rapid stabilization and transport to a trauma center significantly impacted patient outcome.

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller There's been a terrible car accident! It's on Route 1 just outside of Egilsstaðir! The car rolled over!

Dispatcher Okay, I'm sending help. Can you tell me exactly where you are?

Caller It's on Route 1, about 2 kilometers from the airport turnoff, heading west. The car is off the road in the ditch.

Dispatcher Help is on its way. Is anyone injured?

Caller Yes! The driver is badly hurt! He's not moving! I think he's... I don't think he's breathing right! There's so much blood!

Dispatcher Okay, stay calm. Is the patient awake?

Caller No, he's completely unresponsive! He's got a bad head injury! I can see his skull! And his legs... his legs are broken, I think. He's bleeding badly from everywhere!

Dispatcher Okay, the ambulance is on its way. Do you see any other vehicles involved?

Caller No, it was just this one car. It rolled several times. I don't know what to do.

Dispatcher Stay there and keep an eye on the patient. Do not try to move him. Help is on its way. Is there anything else you can tell me about the scene? Is there a fire?

Caller No fire, just the wrecked car and the driver. He's in a really bad way. I'm so scared. There's just so much blood.

Dispatcher Okay, help is coming as fast as possible. Stay on the line with me if you can. Do you know the patients age?

Caller I... I don't know him. He looks maybe 40 or 50 years old. I just saw the car roll over, I stopped to help. Please hurry!