Emergency Scenario 780_f1

Location Information

Full Location:

Hafnarbraut 2, 780 Höfn, ground floor of the main building in the harbor area. One-story concrete building constructed in 1985. Main entrance has a single door. No security features. Current conditions: 8°C, overcast, moderate wind. GPS coordinates: 64.2504° N, 15.2076° W. Nearest landmark: Hornafjörður harbor.

Municipality: Höfn

Postal Code: 780

Emergency Details

Type: Cardiac Arrest

Priority Level: F1

Response Time Goal: Immediate (0-15 minutes)

Description:

68-year-old male, collapsed at harbor. Primary symptoms: Unresponsive, not breathing, no pulse detected. Secondary symptoms: Cyanosis. Patient found lying on the ground near his fishing boat. Medical history: Previous myocardial infarction 5 years ago, treated with stent placement, hypertension, hyperlipidemia. Medications: Aspirin 75mg daily, Atorvastatin 40mg daily, Metoprolol 50mg twice daily. No known allergies. Last meal was a light lunch at 13:00.

History of Events

Timeline:
14:15 hours: Patient was seen walking on the dock, appeared normal.
14:20 hours: Patient suddenly collapsed, no witnessed fall.
14:21 hours: Bystander (caller) found patient unresponsive, not breathing, and called emergency services.
14:22 hours: Current time, patient still unresponsive, bystander initiated chest compressions as instructed.

Prior Events: Patient reported mild chest discomfort yesterday but attributed it to indigestion. No recent illnesses or injuries. Last medical check-up 6 months ago, routine follow-up. Patient is a retired fisherman and lives with his wife.

Diagnostics

Initial Assessment

Initial Impression: Cardiac Arrest
Justification for F1 Classification:
- Unresponsive, not breathing, pulseless patient
- Time-critical emergency requiring immediate life-saving interventions
- High risk of mortality without immediate advanced care

Differential Diagnoses:
1. Cardiac Arrest (most likely)
2. Sudden Cardiac Death (high probability)
3. Massive Pulmonary Embolism (less likely but possible)
4. Severe Hypoglycemia (less likely given no history of diabetes)

Required Actions:
- Dispatch of ground EMS with ALS capabilities immediately
- Dispatch of local fire department for AED support
- Pre-arrival instructions to caller for CPR
- Notification of hospital for potential code blue activation

Final Diagnosis

Final Diagnosis: Ventricular Fibrillation leading to Cardiac Arrest
Key Findings:
- Initial rhythm on AED was ventricular fibrillation
- Defibrillation was successful in restoring sinus rhythm
- Post-resuscitation ECG showed ST-segment elevation in anterior leads
- Patient was transported to hospital and underwent emergent percutaneous coronary intervention (PCI)

Outcome validated F1 priority assignment. Rapid defibrillation was critical for patient survival. Patient made a full recovery after PCI.

Learning Points:
1. F1 classification essential for timely response in cardiac arrest cases
2. Bystander CPR and rapid defibrillation are crucial for patient survival
3. Initial assessment accurately identified the need for immediate intervention

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller A man has collapsed here at the harbor! He's not breathing!

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

Caller It's Hafnarbraut 2, at the harbor in Höfn, near the main building. He's next to his fishing boat.

Dispatcher Help is on its way. Is he responsive? Can you see him breathing?

Caller No, he's completely out. I can't see him breathing. He's not moving!

Dispatcher Okay, I need you to check for a pulse. Can you feel anything in his neck?

Caller (Pause, sounds distressed) No, I can't feel anything. I don't think he has a pulse!

Dispatcher Okay, this is critical. I'm going to guide you through CPR. Place your hands in the center of his chest, and push hard and fast.

Caller Okay, I'm doing it. Pushing hard and fast, like you said.

Dispatcher That's good. Keep doing that until help arrives. The ambulance is on its way. Do you know his name or any medical history?

Caller I think his name is Jón. I don't know anything else about him. I'll keep pushing.

Dispatcher Okay, keep going. Help is very close. Do not stop unless he starts breathing or help arrives.

Caller Okay, I understand. I will keep doing compressions. Please hurry!