Emergency Scenario 550_f2

Location Information

Full Location:

Aðalgata 14, 550 Sauðárkrókur, ground floor apartment. Two-story wooden building built in 1955, with a single main entrance. Street parking available. No security features. Current conditions: 7°C, overcast, light wind, good visibility. GPS coordinates: 65.7475° N, 19.6422° W. Nearest landmark: Sauðárkrókur Swimming Pool.

Municipality: Sauðárkrókur

Postal Code: 550

Emergency Details

Type: Neurological Symptoms

Priority Level: F2

Response Time Goal: Urgent (15-30 minutes)

Description:

68-year-old male, experiencing sudden onset of right-sided weakness and slurred speech. Primary symptoms: Right arm and leg weakness, difficulty speaking. Secondary symptoms: Mild headache, dizziness. Patient is conscious but confused. No recent trauma. Patient found by his wife in the living room. Medical history: Hypertension, type 2 diabetes. Medications: Metformin 1000mg twice daily, Lisinopril 20mg daily, Atorvastatin 20mg daily. No known allergies. Last meal was a light lunch at 12:00.

History of Events

Timeline:
13:45 hours: Patient was watching TV and appeared normal.
14:00 hours: Wife noticed patient's speech was slurred and he was having difficulty moving his right arm.
14:05 hours: Patient's right leg became weak, he became confused.
14:08 hours: Wife called emergency services.
14:10 hours: Current time, patient is conscious but confused, right-sided weakness and slurred speech persists.

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

Diagnostics

Initial Assessment

Initial Impression: Suspected Acute Stroke
Justification for F2 Classification:
- Sudden onset of focal neurological deficits (right-sided weakness, slurred speech)
- Potential for rapid deterioration and irreversible damage
- Time-sensitive condition requiring rapid medical intervention

Differential Diagnoses:
1. Ischemic Stroke (high probability)
2. Hemorrhagic Stroke (possible)
3. Transient Ischemic Attack (TIA) (less likely given persistent symptoms)
4. Hypoglycemia (less likely given patient's diabetes history and recent meal)
5. Seizure (less likely given lack of convulsive activity)

Required Actions:
- Dispatch of ground EMS with ALS capabilities
- Pre-hospital stroke assessment initiation
- Preparation for rapid transport to nearest hospital with stroke services
- Early notification of hospital stroke team

Final Diagnosis

Final Diagnosis: Acute Ischemic Stroke
Key Findings:
- CT scan of the brain confirmed an acute ischemic stroke in the left middle cerebral artery (MCA) territory.
- Patient's neurological deficits were consistent with MCA stroke.
- No evidence of hemorrhage on CT scan.

Outcome validated F2 priority assignment. Rapid dispatch and pre-hospital stroke assessment were crucial. Patient received thrombolytic therapy within the recommended time window. Neurological deficits improved but not fully resolved.

Learning Points:
1. F2 classification appropriate due to the need for timely intervention.
2. Initial assessment accurately identified the high likelihood of stroke.
3. Prompt pre-hospital stroke assessment and rapid transport contributed to improved patient outcome.

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller My husband, I think he's having a stroke! He can't move his right arm and his speech is slurred.

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

Caller It's Aðalgata 14 in Sauðárkrókur. We are on the ground floor.

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

Caller He was watching TV and then suddenly his speech became strange and he couldn't lift his right arm. Now he can't move his right leg either, and he seems confused.

Dispatcher Is he awake and talking to you?

Caller Yes, he's awake but he's confused. He's trying to talk but it's hard to understand him.

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. Do you know what time this started?

Caller I think it started about 20 minutes ago. I noticed it first about 15 minutes ago, when his speech became slurred.

Dispatcher Okay, thank you. The ambulance will be there as soon as possible.

Caller Okay, I will wait here with him.