Miðbær 3, 900 Vestmannaeyjar, single-story commercial building. Constructed in 1960, concrete and wood. Main entrance faces the street, no other exits. No security features. Current conditions: 10°C, overcast, good visibility. GPS coordinates: 63.4413° N, 20.2751° W. Nearest landmark: Landakirkja Church.
45-year-old male, sustained severe injuries from a workplace accident involving a fall from a significant height. Primary symptoms: Unresponsive, severe head trauma with visible skull fracture, agonal breathing, profuse bleeding from head wound. Secondary symptoms: Possible multiple fractures, open fracture of the right tibia, cyanosis around lips. Patient found lying on the concrete floor of a warehouse. No prior medical history provided by caller. No known allergies. Last meal unknown. Scene described as chaotic with panicked bystanders.
Timeline: 1000 hours: Patient was working on a high scaffolding inside the warehouse. 1002 hours: Patient fell approximately 6 meters to the concrete floor. 1003 hours: Coworkers found patient unresponsive, immediately called emergency services. 1005 hours: Current time, patient still unresponsive, agonal breathing, profuse bleeding from head wound. Prior Events: Patient is a construction worker. No prior known medical incidents. Patient was reportedly wearing a safety harness, but it appears to have failed. The warehouse is poorly lit and cluttered with equipment. The patient's coworkers are inexperienced in first aid.
Initial Impression: Severe Traumatic Brain Injury with Multiple Trauma Justification for F1 Classification: - Unresponsive patient with agonal breathing indicating imminent respiratory arrest. - Severe head trauma with visible skull fracture and profuse bleeding, suggesting critical brain injury. - Open fracture and possible multiple injuries indicate significant trauma. - Cyanosis suggests hypoxemia, further increasing urgency. Differential Diagnoses: 1. Severe Traumatic Brain Injury (highest probability) 2. Multiple Fractures with Internal Bleeding (high probability) 3. Spinal Cord Injury (high probability) 4. Hemorrhagic Shock (high probability) Required Actions: - Immediate dispatch of ground EMS with ALS capabilities and rapid transport to nearest trauma center. - Early notification to trauma center for preparation. - Advanced airway management and hemorrhage control. - Spinal immobilization and rapid extrication.