Emergency Scenario 700_f1

Location Information

Full Location:

Miðvangur 2, 700 Egilsstaðir. Single-story detached residential house, built in 1985. Main entrance is on the south side, accessible by a short paved walkway. No security features. Ample parking in the driveway. Current conditions: 8°C, overcast, light wind, good visibility. GPS coordinates: 65.2639° N, 14.3944° W. Nearest landmark: Egilsstaðir Airport.

Municipality: Egilsstaðir

Postal Code: 700

Emergency Details

Type: Major Trauma

Priority Level: F1

Response Time Goal: Immediate (0-15 minutes)

Description:

35-year-old male, involved in a severe ATV accident. Primary symptoms: Unresponsive, agonal breathing, significant head trauma with visible skull fracture, multiple open fractures of the left leg and arm, and heavy bleeding. Secondary symptoms: None reported due to patient's unresponsiveness. Patient found lying beside overturned ATV on a rural track approximately 500 meters from the main road. Medical history: No known allergies, no regular medications, no significant past medical history. Last meal unknown. Incident occurred approximately 5 minutes prior to the call.

History of Events

Timeline:
14:10 hours: Patient was riding ATV on a rough track.
14:12 hours: ATV overturned, patient ejected. Bystander (caller) witnessed the incident.
14:13 hours: Bystander assessed patient, found him unresponsive, with significant injuries, and called emergency services.
14:15 hours: Current time, patient remains unresponsive, with agonal breathing and severe injuries.

Prior Events: No prior incidents known. Patient was alone when the accident occurred. The track is rarely used and is not well-maintained.

Diagnostics

Initial Assessment

Initial Impression: Severe Traumatic Injury with Suspected Head Injury and Multiple Fractures
Justification for F1 Classification:
- Patient is unresponsive with agonal breathing, indicating a life-threatening condition.
- Significant head trauma and multiple open fractures suggest a high risk of rapid deterioration.
- Immediate intervention is required to stabilize the patient and prevent further complications.

Differential Diagnoses:
1. Traumatic Brain Injury (high probability)
2. Hemorrhagic Shock (high probability due to open fractures and bleeding)
3. Cervical Spine Injury (high probability given mechanism of injury)
4. Pneumothorax (potential complication of chest trauma)
5. Multiple Fractures (confirmed by caller report)

Required Actions:
- Dispatch of ground EMS with ALS capabilities and air ambulance if available.
- Immediate transport to the nearest trauma center.
- Rapid sequence intubation (RSI) and airway management.
- Hemorrhage control and fluid resuscitation.
- C-spine immobilization.

Final Diagnosis

Final Diagnosis: Severe Traumatic Brain Injury (TBI), Hemorrhagic Shock, Multiple Open Fractures, and Pneumothorax
Key Findings:
- CT scan confirmed severe TBI with subdural hematoma and skull fracture.
- Patient was in hemorrhagic shock due to multiple open fractures and internal bleeding.
- Chest X-ray revealed a pneumothorax.
- Patient required immediate surgical intervention and intensive care.

Outcome validated F1 priority assignment. Rapid transport and advanced life support were crucial. Patient underwent multiple surgeries and remained in critical condition for several days.

Learning Points:
1. F1 classification was essential for survival.
2. Initial assessment accurately identified the critical nature of the injuries.
3. Aggressive resuscitation and rapid transport were necessary to manage the patient's complex injuries.

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller Oh my god! There's been an accident! A man on an ATV... he's badly hurt!

Dispatcher Okay, stay calm. Where are you located?

Caller We're on a track near Miðvangur 2, in Egilsstaðir. About 500 meters from the road. He's... he's not moving! The ATV flipped over!

Dispatcher Is he awake? Is he breathing?

Caller No, he's not awake! He's... he's breathing, but it's like... gasping! There's so much blood! His head... his head is bleeding, and his leg... I think it's broken!

Dispatcher Okay, help is on its way. Can you tell me your name and what is your social security number?

Caller My name is Jónas Einarsson, and my kennitala is ******-****. Please hurry!

Dispatcher We're sending an ambulance now. Do not move him, stay with him, and try to keep him still. We are also sending a helicopter. We will keep you updated.

Caller Okay, I'll stay here. Please, hurry!