Emergency Scenario 465_f2

Location Information

Full Location:

Hafnargata 11, 465 Bíldudalur, ground floor apartment. Two-story wooden building constructed in 1950. Main entrance on street level. No elevator, access through front door. Street parking available. Building equipped with basic smoke detectors. Current conditions: 8°C, overcast, moderate visibility, light wind. GPS coordinates: 65.7358° N, 23.5389° W. Nearest landmark: Bíldudalur harbor.

Municipality: Bíldudalur

Postal Code: 465

Emergency Details

Type: Neurological Symptoms

Priority Level: F2

Response Time Goal: Urgent (15-30 minutes)

Description:

72-year-old male, sudden onset of left-sided weakness and slurred speech. Primary symptoms: Left arm and leg weakness, difficulty speaking, facial droop on the left side. Secondary symptoms: Mild confusion, headache. Patient alert but appears distressed. Medical history: Hypertension, Type 2 Diabetes. Medications: Metformin 1000mg 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 television, started complaining of headache.
1420 hours: Patient reported left-sided weakness, began slurring his speech.
1425 hours: Patient's wife noticed facial droop and called emergency services.
1428 hours: Current time, patient sitting on couch, left side weakness persists.

Prior Events: Patient reports no recent illnesses or injuries. Last medical check-up 6 months ago, routine follow-up for diabetes and hypertension. No history of stroke or TIA. Patient lives with his wife.

Diagnostics

Initial Assessment

Initial Impression: Suspected Acute Stroke (CVA)
Justification for F2 Classification:
- Sudden onset of focal neurological deficits (left-sided weakness, slurred speech, facial droop)
- High probability of stroke based on presentation and risk factors (hypertension, diabetes)
- Time-sensitive condition requiring rapid assessment and potential thrombolytic therapy

Differential Diagnoses:
1. Ischemic Stroke (high probability)
2. Hemorrhagic Stroke (possibility, requires imaging to confirm)
3. Transient Ischemic Attack (TIA) (less likely given persistence of symptoms)
4. Hypoglycemia (less likely given patient's diabetic control)
5. Bell's Palsy (less likely given accompanying limb weakness)

Required Actions:
- Dispatch of ground EMS with ALS capabilities
- Rapid transport to nearest hospital with stroke center
- Pre-notification of hospital stroke team
- Continuous monitoring of vital signs and neurological status

Final Diagnosis

Final Diagnosis: Acute Ischemic Stroke, Left Middle Cerebral Artery (MCA) Territory
Key Findings:
- CT scan of the brain confirmed an acute ischemic stroke in the left MCA territory
- Patient's neurological deficits were consistent with the imaging findings
- NIH Stroke Scale score indicated moderate severity

Outcome validated F2 priority assignment. Rapid transport and treatment initiation were crucial. Patient received thrombolytic therapy within the treatment window and showed improvement in symptoms.

Learning Points:
1. F2 classification was appropriate due to the time-sensitive nature of stroke
2. Initial assessment accurately identified the high likelihood of stroke
3. Rapid response and pre-notification of the hospital stroke team were critical for optimal patient outcome

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller My husband is not well! I think he's having a stroke.

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

Caller It's Hafnargata 11, in Bíldudalur. We are on the ground floor.

Dispatcher Help is on its way. Can you tell me what's happening?

Caller He suddenly started feeling weak on his left side. His speech is slurred, and his face looks droopy on one side. It was very sudden.

Dispatcher Is he awake and talking to you?

Caller Yes, he's awake but he seems confused and he has a headache. He's trying to talk but it's difficult to understand him.

Dispatcher Does he have any medical conditions?

Caller Yes, he has high blood pressure and type 2 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 will wait here with him. Please hurry!