Miðbær 1, 900 Vestmannaeyjar. Two-story wooden building, built in 1950, currently a fish processing plant. Main entrance is a large loading dock door. Secondary entrance on the side, usually locked. No elevator, access to the second floor is by a single narrow stairwell. Street parking available. Security is limited to basic door locks. Current conditions: 8°C, overcast, light drizzle, moderate visibility. GPS coordinates: 63.4419° N, 20.2693° W. Nearest landmark: Vestmannaeyjar Harbour.
45-year-old male, sustained a severe injury at work. Primary symptoms: Unresponsive, significant head trauma with visible skull fracture, profuse bleeding, agonal respirations. Secondary symptoms: Pale skin, possible chest injury. Patient found on the floor of the processing plant. No known medical history. No known allergies. Medications unknown. Last meal was lunch at 12:00. Scene is chaotic with loud machinery noises.
Timeline: 1345 hours: Patient was working near a conveyor belt, witnesses report a large metal object fell and struck him on the head. 1346 hours: Patient immediately collapsed and became unresponsive. 1347 hours: Coworker initiated emergency call. 1348 hours: Current time, patient still unresponsive, agonal respirations noted, heavy bleeding from head wound. Prior Events: Patient is generally healthy, no known medical issues. No recent injuries or illnesses. No previous hospital admissions.
Initial Impression: Severe Traumatic Brain Injury with Skull Fracture Justification for F1 Classification: - Unresponsive patient with significant head trauma and active bleeding - Agonal respirations indicate imminent respiratory failure - High risk of rapid deterioration and death without immediate intervention - Requires immediate dispatch of ALS ambulance and air transport preparation Differential Diagnoses: 1. Severe Traumatic Brain Injury (highest probability) 2. Subdural/Epidural Hematoma (high probability) 3. Cervical Spine Injury (assume present until ruled out) 4. Cardiac Arrest (possible secondary to trauma) Required Actions: - Immediate dispatch of ground EMS with ALS capabilities - Preparation for air transport to Reykjavik trauma center - Airway management and ventilation support - Hemorrhage control and stabilization - Rapid transport to hospital