Emergency Scenario 780_f1

Location Information

Full Location:

Hafnarbraut 15, 780 Vopnafjörður. Two-story residential building, built in 1965. Main entrance on the ground floor with no steps. No elevator. Parking available on the street. No security system. Current conditions: 8°C, overcast, light wind, good visibility. GPS coordinates: 65.7727° N, 14.8388° W. Nearest landmark: Vopnafjörður harbor.

Municipality: Vopnafjörður

Postal Code: 780

Emergency Details

Type: Stroke Symptoms

Priority Level: F1

Response Time Goal: Immediate (0-15 minutes)

Description:

72-year-old male, suspected stroke. Primary symptoms: Sudden onset of right-sided facial droop, right arm weakness, and slurred speech. Patient is conscious but confused. Secondary symptoms: Mild headache, dizziness. Patient was found by his wife in the living room. Medical history: Hypertension, type 2 diabetes, history of transient ischemic attack (TIA) 2 years ago. Medications: Metformin 500mg twice daily, Amlodipine 10mg daily, Atorvastatin 20mg daily. No known allergies. Last meal was a light lunch at 13:00.

History of Events

Timeline:
1410 hours: Patient was watching television and appeared normal.
1415 hours: Wife noticed patient’s speech was slurred, face drooping on right side, and right arm weak.
1416 hours: Wife attempted to speak with patient, he appeared confused and had difficulty responding.
1417 hours: Wife called emergency services.
1420 hours: Current time, patient is still in the living room, wife is with him.

Prior Events: Patient had a TIA 2 years ago, fully recovered. No recent hospitalizations or significant changes in medication. Routine check-up 6 months ago, normal results.

Diagnostics

Initial Assessment

Initial Impression: Suspected Acute Stroke
Justification for F1 Classification:
- Sudden onset of focal neurological deficits (facial droop, arm weakness, speech difficulty)
- High probability of stroke based on symptoms and history of TIA
- Time-critical condition requiring immediate medical intervention to minimize neurological damage

Differential Diagnoses:
1. Ischemic Stroke (most likely given symptoms)
2. Hemorrhagic Stroke (less likely but must be considered)
3. Transient Ischemic Attack (TIA) (possible but less likely given severity of symptoms)
4. Hypoglycemia (less likely given history of diabetes and recent meal)

Required Actions:
- Dispatch of ground EMS with ALS capabilities immediately
- Early notification of hospital stroke team
- Preparation for immediate transport to stroke center
- Pre-hospital stroke assessment protocol initiation

Final Diagnosis

Final Diagnosis: Acute Ischemic Stroke, Left Middle Cerebral Artery (MCA) Territory
Key Findings:
- CT scan confirmed an acute ischemic stroke in the left MCA territory
- Patient's NIH Stroke Scale score was 12 upon arrival at the hospital
- Thrombolytic therapy was initiated within the therapeutic window.
- No evidence of hemorrhage

Outcome validated F1 priority assignment. Rapid dispatch and hospital notification were crucial. Patient underwent successful thrombectomy and received post-stroke rehabilitation.

Learning Points:
1. F1 classification was essential for this time-sensitive emergency
2. Initial assessment accurately identified the high probability of a stroke
3. Prompt pre-hospital care and early hospital notification improved patient outcome.

Emergency Call Transcript

Dispatcher Neyðarlínan, hvað er að?

Caller Hjálp! Maðurinn minn er veikur. Ég held hann sé að fá slag.

Dispatcher Allt í lagi, ég sendi hjálp. Hvert er heimilisfangið?

Caller Það er Hafnarbraut 15 í Vopnafirði.

Dispatcher Hjálp er á leiðinni. Hvað gerðist?

Caller Hann var að horfa á sjónvarpið og allt í einu byrjaði andlitið á honum að síga á hægri hlið, hann getur ekki hreyft hægri handlegginn almennilega og hann talar óskýrt.

Dispatcher Er hann með meðvitund?

Caller Já, en hann er ruglaður. Ég held hann skilji ekki alveg hvað ég er að segja.

Dispatcher Hefur hann einhverja sjúkdóma?

Caller Já, hann er með háan blóðþrýsting og sykursýki. Hann hefur líka fengið heilablóðfall fyrir tveimur árum.

Dispatcher Allt í lagi, sjúkrabíllinn er á leiðinni. Ekki reyna að hreyfa hann. Vertu hjá honum og reyndu að halda honum rólegum.

Caller Allt í lagi, takk fyrir. Ég bíð hér með honum.