Emergency Scenario 400_f2

Location Information

Full Location:

Hafnarstræti 14, 400 Ísafjörður, second floor apartment 2B. Three-story wooden building constructed in 1955. Main entrance has a coded lock, code is 2468. No elevator, only a central stairwell. Street parking available. Building has smoke detectors. Current conditions: 8°C, cloudy, moderate wind, good visibility. GPS coordinates: 66.0734° N, 23.1239° W. Nearest landmark: Ísafjörður Church.

Municipality: Ísafjörður

Postal Code: 400

Emergency Details

Type: Neurological Symptoms

Priority Level: F2

Response Time Goal: Urgent (15-30 minutes)

Description:

68-year-old male, sudden onset of left-sided weakness and slurred speech. Patient is conscious but confused. Primary symptoms: Left arm and leg weakness, facial droop on left side, difficulty speaking. Secondary symptoms: Dizziness, headache. Patient is sitting in a chair in the living room. Medical history: Hypertension, type 2 diabetes. Medications: Metformin 500mg twice daily, Lisinopril 10mg daily, Atorvastatin 20mg daily. No known allergies. Last meal was lunch at 13:00.

History of Events

Timeline:
1415 hours: Patient was watching TV, suddenly developed left-sided weakness and slurred speech.
1416 hours: Patient tried to stand, experienced dizziness and fell back into his chair.
1417 hours: Patient called his wife (caller) for help.
1418 hours: Caller arrived home, found patient with the symptoms described.
1420 hours: Caller called emergency services.
1422 hours: Current time, patient remains seated in the chair, conscious but confused.

Prior Events: Patient had a minor fall 2 months ago, no head injury. Last medical check-up was 6 months ago, routine follow-up. Patient reports occasional headaches. No recent illnesses or injuries.

Diagnostics

Initial Assessment

Initial Impression: Suspected Acute Stroke
Justification for F2 Classification:
- Sudden onset of neurological deficits (left-sided weakness, slurred speech, facial droop)
- Time-sensitive condition requiring rapid medical intervention to minimize neurological damage
- Presence of risk factors (hypertension, diabetes)

Differential Diagnoses:
1. Ischemic Stroke (most likely)
2. Hemorrhagic Stroke (less likely but possible)
3. Transient Ischemic Attack (TIA) (possible but symptoms are more pronounced)
4. Hypoglycemia (less likely given patient's diabetic history, but should be checked)
5. Intracranial mass (less likely given sudden onset)

Required Actions:
- Dispatch of ground EMS with ALS capabilities
- Pre-hospital stroke assessment (FAST assessment)
- Rapid transport to nearest hospital with stroke treatment capabilities
- Early notification of hospital to prepare for potential thrombolysis or thrombectomy

Final Diagnosis

Final Diagnosis: Acute Ischemic Stroke (Left Middle Cerebral Artery)
Key Findings:
- CT scan of the brain revealed a large area of hypodensity in the left middle cerebral artery territory
- Patient's symptoms persisted and worsened during transport
- Patient received intravenous thrombolysis upon arrival at the hospital

Outcome validated F2 priority assignment. Rapid dispatch and transport were critical. Patient had a good outcome with minimal residual deficits after rehabilitation.

Learning Points:
1. F2 classification was appropriate due to the need for rapid intervention
2. Initial assessment accurately identified stroke as the most likely cause
3. Prompt pre-hospital stroke assessment and early hospital notification were crucial for successful treatment

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller My husband, he's not well! He suddenly can't move his left side and his speech is slurred.

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

Caller It's Hafnarstræti 14, apartment 2B, second floor in Ísafjörður.

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

Caller He was just watching TV and then suddenly he couldn't move his left arm and leg. He's talking funny too, like he can't get the words out.

Dispatcher Is he awake and talking to you?

Caller Yes, he's awake but he seems confused. He tried to stand but he fell back into his chair. He said he was dizzy.

Dispatcher Does he have any medical conditions?

Caller Yes, he has high blood pressure and diabetes. He takes medication for both.

Dispatcher Okay, the ambulance is on its way. Don't try to move him. Stay with him and keep him calm.

Caller Okay, thank you. I'm very worried.