Emergency Scenario 780_f1

Location Information

Full Location:

Hafnarbraut 10, 780 Höfn, Ground floor of a single-story concrete building, built in 1985, main entrance facing the harbor. No security features, street parking available. Current conditions: 3°C, light snow, moderate visibility. GPS coordinates: 64.2531° N, 15.2086° W. Nearest landmark: Höfn harbor.

Municipality: Höfn

Postal Code: 780

Emergency Details

Type: Major Trauma

Priority Level: F1

Response Time Goal: Immediate (0-15 minutes)

Description:

35-year-old male, involved in a high-speed motorcycle accident. Primary symptoms: Unresponsive, severe head trauma, visible skull fracture, agonal breathing. Secondary symptoms: Multiple abrasions and lacerations, possible internal bleeding. Patient found lying on the road, helmet partially removed. Medical history: No known allergies, no known medications, no significant past medical history. Last meal was a light lunch at 13:00. Patient was wearing full motorcycle gear but the helmet is damaged.

History of Events

Timeline:
1510 hours: Motorcycle accident occurred at high speed, patient thrown from bike.
1511 hours: Bystander (caller) found patient unresponsive and called emergency services.
1512 hours: Current time, patient still unresponsive, agonal breathing. Bystander has not moved the patient.

Prior Events: Patient was riding his motorcycle on Hafnarbraut. No known pre-existing conditions or recent injuries. No recent healthcare contacts. Patient was alone at the time of the accident.

Diagnostics

Initial Assessment

Initial Impression: Severe Traumatic Brain Injury (TBI) with possible other internal injuries.
Justification for F1 Classification:
- Unresponsive patient with visible skull fracture and agonal breathing indicates immediate life-threatening condition.
- High-speed trauma suggests high risk of internal injuries.
- Time-critical intervention is essential for survival.

Differential Diagnoses:
1. Severe Traumatic Brain Injury (high probability)
2. Hemorrhagic Shock (high probability)
3. Spinal Cord Injury (high probability)
4. Tension Pneumothorax (possible)

Required Actions:
- Immediate dispatch of ALS ground EMS and air ambulance (if available).
- Advanced airway management.
- Rapid transport to nearest trauma center.
- Notification of hospital trauma team.

Final Diagnosis

Final Diagnosis: Severe Traumatic Brain Injury (Diffuse Axonal Injury), Hemorrhagic Shock, Multiple Rib Fractures, and Splenic Rupture.
Key Findings:
- CT scan revealed diffuse axonal injury, multiple skull fractures, and evidence of intracranial bleeding.
- Ultrasound confirmed significant intra-abdominal bleeding from a ruptured spleen.
- Patient developed severe hemorrhagic shock requiring massive transfusion.
- Patient's condition deteriorated rapidly despite interventions.

Outcome validated F1 priority assignment. Rapid dispatch and aggressive interventions were critical but ultimately insufficient. Patient died in the hospital despite all efforts.

Learning Points:
1. F1 classification was absolutely necessary given the severity of injuries.
2. Initial assessment accurately identified the critical nature of the patient's condition.
3. The extent of the injuries was more severe than initially suspected, emphasizing the importance of rapid transport to a trauma center.

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller There's been a terrible motorcycle accident! The rider is not moving, and he's badly hurt.

Dispatcher Okay, I'm sending help immediately. Where exactly is this accident?

Caller It's on Hafnarbraut 10 in Höfn, right in front of the harbor.

Dispatcher Help is on its way. Can you tell me what you see? Is he breathing?

Caller He's not moving at all. I think he's breathing, but it's like gasping. There's blood, and his head looks really bad. He was wearing a helmet, but it's broken.

Dispatcher Okay, do not move him. Is he awake? Can he talk to you?

Caller No, he's completely unconscious. I don't think he's going to make it. There's so much blood.

Dispatcher Okay, stay calm. Help is on its way. Just stay with him and don't move him. Do you know his name or anything about him?

Caller No, I don't know him. I just saw the accident happen. Please hurry!

Dispatcher Ambulance and air support are on their way. Stay with him and wait for them to arrive.