Emergency Scenario 780_f1

Location Information

Full Location:

Hafnarbraut 17, 780 Vopnafjörður. Single-story wooden residential building built in 1965. Main entrance is via a single door with a standard lock. No elevator. Street parking is available. Building is equipped with smoke detectors. Current conditions: 8°C, overcast, light wind, good visibility. GPS coordinates: 65.7608° N, 14.8352° W. Nearest landmark: Vopnafjörður Harbor.

Municipality: Vopnafjörður

Postal Code: 780

Emergency Details

Type: Cardiac Arrest

Priority Level: F1

Response Time Goal: Immediate (0-15 minutes)

Description:

72-year-old male, collapsed at home. Primary symptoms: Unresponsive, not breathing, no pulse detected. Secondary symptoms: None reported. Patient found lying on the floor in the living room. Medical history: History of myocardial infarction 5 years ago, hypertension, type 2 diabetes. Medications: Aspirin 75mg daily, Metoprolol 50mg twice daily, Metformin 500mg twice daily, Atorvastatin 20mg daily. No known allergies. Last meal was a light lunch at 13:00.

History of Events

Timeline:
1510 hours: Patient was watching television, reported feeling unwell, became pale
1512 hours: Patient collapsed suddenly, daughter witnessed collapse
1513 hours: Daughter checked for responsiveness, breathing, and pulse, found none
1514 hours: Daughter called emergency services
1515 hours: Current time, patient still unresponsive, no breathing, no pulse

Prior Events: Patient had complained of mild chest pain on and off for the past week, which he attributed to indigestion. He had a routine check-up 6 months ago, which showed stable chronic conditions. No recent hospitalizations. Patient lives with his daughter.

Diagnostics

Initial Assessment

Initial Impression: Cardiac Arrest
Justification for F1 Classification:
- Patient is unresponsive, not breathing, and pulseless.
- This is a life-threatening emergency requiring immediate intervention
- Time-critical condition, requiring immediate dispatch of ALS resources

Differential Diagnoses:
1. Cardiac Arrest (most likely)
2. Sudden Cardiac Death (possible)
3. Severe Hypoglycemia (less likely given history)
4. Stroke (less likely given sudden onset and lack of focal deficits)

Required Actions:
- Dispatch of ground EMS with ALS capabilities immediately
- Dispatch of local fire department with AED capabilities
- Instructions to caller for immediate initiation of CPR
- Notification of receiving hospital of incoming cardiac arrest

Final Diagnosis

Final Diagnosis: Ventricular Fibrillation leading to Cardiac Arrest
Key Findings:
- Initial ECG on arrival showed ventricular fibrillation
- CPR and defibrillation were initiated immediately
- Patient achieved return of spontaneous circulation (ROSC) after 3 shocks
- Post-ROSC ECG showed ST-segment elevation indicating acute myocardial infarction

Outcome validated F1 priority assignment. Rapid dispatch, CPR, and defibrillation were critical for survival. Patient was transported to the nearest hospital for further treatment.

Learning Points:
1. F1 classification appropriate due to the need for immediate intervention
2. Early recognition of cardiac arrest and initiation of CPR were essential
3. Rapid defibrillation was crucial for successful resuscitation

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller My father just collapsed! He's not breathing, I don't think he has a pulse!

Dispatcher Okay, I'm sending help right away. What is your address?

Caller It's Hafnarbraut 17 in Vopnafjörður.

Dispatcher Help is on its way. Is he awake?

Caller No, he's completely unresponsive. He was watching TV and then just fell over.

Dispatcher Okay, I need you to check if he's breathing. Put your ear near his mouth and nose. Can you feel or hear any breath?

Caller No, I don't feel or hear anything. Oh my god, he's not breathing!

Dispatcher Okay, I need you to start chest compressions immediately. Place the heel of one hand in the center of his chest, and the other hand on top. Push hard and fast. About two compressions per second.

Caller Okay, okay, I'm doing it. I'm pushing hard, is this right?

Dispatcher Yes, that's right. Keep going. The ambulance is on its way. Do you know if he has any medical conditions?

Caller Yes, he had a heart attack a few years ago, high blood pressure and diabetes. He takes several medications.

Dispatcher Okay, keep doing chest compressions until the ambulance arrives. They will be there very soon.

Caller Okay, I'm still doing it, I'm so scared!