Emergency Scenario 400_f2

Location Information

Full Location:

Hafnarstræti 2, 400 Ísafjörður, ground floor apartment 1B. Two-story wooden residential building constructed in 1955. Main entrance has a single door, no intercom. Street parking available. Building equipped with smoke detectors. Current conditions: 8°C, overcast, moderate visibility, light rain. GPS coordinates: 66.0750° N, 23.1290° W. Nearest landmark: Ísafjörður Hospital.

Municipality: Ísafjörður

Postal Code: 400

Emergency Details

Type: Obstetric Emergency

Priority Level: F2

Response Time Goal: Urgent (15-30 minutes)

Description:

28-year-old female, 38 weeks pregnant, experiencing sudden onset of severe abdominal pain and vaginal bleeding. Patient reports contractions every 5 minutes, lasting 60 seconds. Patient is conscious, anxious, and pale. No prior complications reported in current pregnancy. Patient is lying on her bed. Medical history: No known allergies, no chronic conditions. Medications: Prenatal vitamins. Last meal was a light lunch at 13:00.

History of Events

Timeline:
1415 hours: Patient felt first mild abdominal pain
1420 hours: Pain increased in intensity, contractions started
1425 hours: Vaginal bleeding noted
1430 hours: Patient called her husband for help
1435 hours: Husband arrived, called emergency services
1437 hours: Current time, patient in pain, contractions every 5 minutes, vaginal bleeding

Prior Events: Patient had a routine prenatal check-up 3 days ago, no issues reported. This is her first pregnancy. No history of miscarriages or other obstetric complications. No recent illnesses or injuries.

Diagnostics

Initial Assessment

Initial Impression: Suspected Placental Abruption or Preterm Labor
Justification for F2 Classification:
- High probability of a serious obstetric complication based on symptoms (severe pain, bleeding, contractions)
- Potential for fetal distress or maternal hemorrhage
- Time-sensitive condition requiring prompt medical evaluation and intervention

Differential Diagnoses:
1. Placental Abruption (high probability)
2. Preterm Labor (likely given gestational age)
3. Placenta Previa (less likely given pain presentation)
4. Uterine Rupture (less likely given no prior uterine surgery)

Required Actions:
- Dispatch of ground EMS with ALS capabilities
- Initiate maternal and fetal monitoring
- Preparation for transport to nearest hospital with obstetric services
- Early notification to obstetric team at Ísafjörður Hospital

Final Diagnosis

Final Diagnosis: Placental Abruption with Preterm Labor
Key Findings:
- Ultrasound confirmed placental abruption with retroplacental hematoma
- Fetal heart rate monitoring showed signs of fetal distress
- Patient's pain score remained high despite initial analgesia
- Patient was transferred to Ísafjörður Hospital for urgent C-section

Outcome validated F2 priority assignment. Rapid dispatch and transport were critical for both maternal and fetal well-being. Patient delivered a healthy infant via emergency C-section. Maternal blood loss was significant but managed successfully.

Learning Points:
1. F2 classification appropriate due to the need for timely intervention
2. Initial assessment accurately identified the high likelihood of a serious obstetric emergency
3. Prompt transport and communication with the obstetric team contributed to a positive outcome

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller My wife is pregnant, and she's bleeding and in terrible pain! I think something is wrong.

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

Caller It's Hafnarstræti 2, apartment 1B, ground floor in Ísafjörður.

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

Caller She started having bad pains in her stomach, and then she started bleeding. She's 38 weeks pregnant.

Dispatcher Is she awake and talking to you?

Caller Yes, she's awake, but she's in a lot of pain and scared. She says the pain is coming and going.

Dispatcher Does she have any medical conditions or allergies?

Caller No, she doesn't. She's been healthy throughout the pregnancy. She's just taking vitamins.

Dispatcher Okay, the ambulance is on its way. Keep her calm, and don't try to move her. Is there any other bleeding?

Caller Yes, there is. It's still coming. I'm really worried.

Dispatcher Okay, help is on its way. Stay with her and keep her calm. We are sending an ambulance with advanced medical personnel.

Caller Okay, thank you. I will wait here with her.