Emergency Scenario 900_f1

Location Information

Full Location:

Heiðarvegur 14, 900 Vestmannaeyjar. Two-story residential building, built in 1968, concrete construction. Main entrance has a standard lock. No elevator, interior stairwell. Street parking available. Current conditions: 8°C, overcast, light wind, good visibility. GPS coordinates: 63.4418° N, 20.2725° W. Nearest landmark: Vestmannaeyjar Hospital.

Municipality: Vestmannaeyjar

Postal Code: 900

Emergency Details

Type: Cardiac Arrest

Priority Level: F1

Response Time Goal: Immediate (0-15 minutes)

Description:

68-year-old male, collapsed at home. Primary symptoms: Unresponsive, not breathing, no pulse. Patient found by wife. Secondary symptoms: None reported. Patient is lying on the living room floor. Medical history: History of coronary artery disease, previous myocardial infarction 5 years ago, type 2 diabetes. Medications: Metformin 1000mg twice daily, Atorvastatin 40mg daily, Ramipril 5mg daily, Aspirin 75mg daily. No known allergies. Last meal was dinner at 19:00.

History of Events

Timeline:
21:30 hours: Patient and wife were watching TV
21:35 hours: Patient suddenly slumped over, unresponsive
21:36 hours: Wife checked for breathing and pulse, found none
21:37 hours: Wife called emergency services
21:38 hours: Current time, patient still unresponsive, no breathing or pulse

Prior Events: Patient has had chest pain on exertion for the past week, but did not seek medical attention. Last medical check-up 6 months ago, routine follow-up. No recent illnesses or injuries. Patient is a smoker, 1 pack per day for 40 years.

Diagnostics

Initial Assessment

Initial Impression: Cardiac Arrest
Justification for F1 Classification:
- Patient is unresponsive, not breathing, and pulseless
- Time-critical condition requiring immediate intervention
- High probability of life-threatening event

Differential Diagnoses:
1. Cardiac Arrest due to myocardial infarction (most likely)
2. Cardiac Arrest due to arrhythmia (possible)
3. Cardiac Arrest due to other causes (less likely)

Required Actions:
- Immediate dispatch of ground EMS with ALS capabilities
- Dispatch of local fire department for backup
- Dispatch of AED if available in the vicinity
- Pre-arrival instructions for CPR to the caller
- Early hospital notification and activation of cardiac arrest team

Final Diagnosis

Final Diagnosis: Ventricular Fibrillation leading to Cardiac Arrest secondary to Acute Myocardial Infarction
Key Findings:
- ECG upon arrival showed ventricular fibrillation
- Patient responded to defibrillation and ACLS protocols
- Post-ROSC ECG showed ST-segment elevation, confirming acute MI

Outcome validated F1 priority assignment. Rapid dispatch and early defibrillation were critical for patient survival. Patient was transferred to the cardiac care unit for further management.

Learning Points:
1. F1 classification was essential due to the time-sensitive nature of cardiac arrest
2. Early recognition of cardiac arrest by the caller was critical
3. Rapid EMS response and early defibrillation were crucial for a positive outcome

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller My husband! He just collapsed! I don't think he's breathing!

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

Caller Heiðarvegur 14, in Vestmannaeyjar.

Dispatcher Help is on its way. Is he awake?

Caller No! He's not responding. I can't feel a pulse. He's not breathing!

Dispatcher Okay, stay calm. I'm going to guide you. Can you see if there is an AED nearby?

Caller I don't have one here, I don't think so.

Dispatcher Okay. I need you to start chest compressions. Place your hands in the center of his chest, and push hard and fast.

Caller I... I'm trying, I'm doing it. Is help coming?

Dispatcher Yes, they are on their way. Keep doing chest compressions. I'll stay on the line with you.

Caller (Heavy breathing and sounds of chest compressions) Okay, I'm doing it. Please hurry!