Emergency Scenario 780_f1

Location Information

Full Location:

Hafnarbraut 12, 780 Höfn, second floor apartment 2B. Three-story concrete residential building constructed in 1995. Main entrance requires a key or intercom. One central stairwell, no elevator. Street parking available. Building has basic fire safety equipment. Current conditions: 8°C, overcast, light wind, good visibility. GPS coordinates: 64.2509° N, 15.2081° 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, sustained major trauma from a fall from a height. Primary symptoms: Unresponsive, agonal breathing, visible head trauma with significant bleeding, possible spinal injury. Secondary symptoms: Multiple fractures suspected, obvious deformities to right arm and leg. Patient found lying on concrete surface outside the building. Medical history: No known allergies, no regular medications, no significant past medical history. Last meal was a light lunch around 13:00.

History of Events

Timeline:
14:45 hours: Patient was seen working on the roof of the building
14:50 hours: Patient fell from the roof (approximately 8 meters) onto the concrete below
14:51 hours: Caller, a neighbor, discovered the patient and called emergency services
14:52 hours: Current time, patient unresponsive, agonal breathing, visible injuries.

Prior Events: Patient is a construction worker, reported to be in good health. No known recent illnesses or injuries. No history of substance abuse. No recent medical check-ups.

Diagnostics

Initial Assessment

Initial Impression: Severe Head Trauma with Possible Spinal Injury and Multiple Fractures
Justification for F1 Classification:
- Unresponsive patient with agonal breathing
- Significant head trauma and visible bleeding
- High risk of airway compromise and spinal injury
- Immediate life-threatening condition requiring rapid intervention

Differential Diagnoses:
1. Severe Traumatic Brain Injury (high probability)
2. Spinal Cord Injury (high probability)
3. Multiple Fractures (high probability)
4. Internal Hemorrhage (high probability)
5. Tension Pneumothorax (possible due to trauma)

Required Actions:
- Immediate dispatch of ground EMS with ALS capabilities and air ambulance if available
- Rapid assessment of airway, breathing, and circulation
- Spinal immobilization protocols
- Early notification of receiving trauma center

Final Diagnosis

Final Diagnosis: Severe Traumatic Brain Injury with Subdural Hematoma, C6-C7 Spinal Fracture with Cord Compression, Right Femur and Radius Fractures, and Multiple Rib Fractures
Key Findings:
- CT scan revealed a large subdural hematoma and diffuse axonal injury
- Spinal imaging confirmed a C6-C7 fracture with significant cord compression
- X-rays confirmed fractures of the right femur, radius, and multiple ribs
- Patient required immediate intubation and ventilation

Outcome validated F1 priority assignment. Rapid dispatch and advanced life support were critical. Patient underwent emergency neurosurgery and spinal stabilization. Prognosis remains guarded.

Learning Points:
1. F1 classification was essential for rapid response in this multi-system trauma case
2. Initial assessment correctly identified the life-threatening nature of the injuries
3. Rapid transport and advanced trauma care were vital for patient survival

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller Oh my god, there's been a terrible accident! A man has fallen from the roof! He's not moving!

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

Caller It's Hafnarbraut 12, apartment 2B, second floor in Höfn. He's outside on the ground.

Dispatcher Help is on its way. Can you tell me what happened?

Caller He was working on the roof, and then he just fell! I heard a loud thud. He's not moving, he's not breathing right! There's blood everywhere!

Dispatcher Is he awake? Is he talking to you?

Caller No, no, he's completely out! He's just making weird noises. He's hurt really bad. I think he's dying!

Dispatcher Okay, stay calm. Do not move him. Help is on its way. Can you see any obvious injuries?

Caller His head is bleeding badly, and his arm and leg look broken! Please hurry!

Dispatcher An ambulance is on its way. Stay with him and do not move him. We are sending the highest level of help.

Caller Okay, okay, I will stay here. Please hurry!