Emergency Scenario 465_f2

Location Information

Full Location:

Hafnargata 15, 465 Bíldudalur, single-story wooden residential house built in 1955. Main entrance is on the street side. No stairs, one level access. No security features. Street parking available. Current conditions: 8°C, clear skies, good visibility. GPS coordinates: 65.6803° N, 23.5394° 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:

68-year-old male, sudden onset of left-sided weakness and slurred speech. Primary symptoms: Left arm and leg weakness, facial droop on the left side, difficulty speaking. Secondary symptoms: Mild headache, dizziness. Patient is conscious but confused. Patient is sitting in a chair in his living room. Medical history: Hypertension diagnosed 5 years ago, type 2 diabetes. Medications: Metformin 500mg twice daily, Lisinopril 10mg daily. No known allergies. Last meal was a light lunch at 13:00.

History of Events

Timeline:
1430 hours: Patient was watching TV when he suddenly felt weakness on his left side.
1431 hours: Patient tried to stand but had difficulty with balance, slurred speech noticed.
1432 hours: Patient's wife noticed his symptoms and called emergency services.
1435 hours: Current time, patient is conscious but confused, still exhibiting left-sided weakness.

Prior Events: Patient has had no recent illnesses or injuries. Last medical check-up was 6 months ago, routine follow-up for diabetes and hypertension. Patient lives with his wife.

Diagnostics

Initial Assessment

Initial Impression: Suspected Acute Stroke (Cerebrovascular Accident)
Justification for F2 Classification:
- Sudden onset of focal neurological deficits (left-sided weakness, slurred speech, facial droop)
- Time-sensitive condition requiring immediate medical intervention to minimize brain damage
- Potential for rapid deterioration

Differential Diagnoses:
1. Ischemic Stroke (most probable)
2. Hemorrhagic Stroke (possible, requires imaging to confirm)
3. Transient Ischemic Attack (TIA) (less likely given persistent symptoms)
4. Hypoglycemia (less likely given patient's history of diabetes and recent meal)
5. Bell's Palsy (less likely given limb weakness)

Required Actions:
- Dispatch of ground EMS with ALS capabilities
- Immediate transport to the nearest hospital with stroke center capabilities
- Pre-hospital stroke assessment and notification of receiving hospital

Final Diagnosis

Final Diagnosis: Acute Ischemic Stroke (Left Middle Cerebral Artery)
Key Findings:
- CT scan of the brain confirmed an acute ischemic stroke in the territory of the left middle cerebral artery
- Patient's symptoms persisted throughout the assessment and transport
- No evidence of intracranial hemorrhage on imaging

Outcome validated F2 priority assignment. Rapid dispatch and transport were crucial. Patient received thrombolytic therapy upon arrival at the hospital.

Learning Points:
1. F2 classification was appropriate due to the time-sensitive nature of stroke
2. Initial assessment accurately identified the high probability of a stroke
3. Rapid transport to a stroke center is essential for optimal patient outcomes

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 Hafnargata 15 in Bíldudalur.

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

Caller He was just sitting watching TV, and then he suddenly felt weak on his left side. He can't move his arm or leg properly.

Dispatcher Is he awake and talking to you?

Caller Yes, he's awake but he's confused and his speech isn't clear. His face looks droopy on one side.

Dispatcher Does he have any medical conditions?

Caller 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 will wait here with him.