Emergency Scenario 600_f2

Location Information

Full Location:

Hafnarstræti 96, 600 Akureyri, third floor apartment 3B. Five-story reinforced concrete building built in 1995. Main entrance has a key code and intercom. One elevator and a central stairwell. Street parking available. Building equipped with a sprinkler system. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6821° N, 18.0919° W. Nearest landmark: Akureyri Art Museum.

Municipality: Akureyri

Postal Code: 600

Emergency Details

Type: Neurological Symptoms

Priority Level: F2

Response Time Goal: 15-30 minutes

Description:

68-year-old male, sudden onset of right-sided weakness and slurred speech. Primary symptoms: Right arm and leg weakness, facial droop on the right side, difficulty speaking. Secondary symptoms: Mild headache, confusion. Patient is awake but disoriented. Patient is sitting in a chair in the living room. Medical history: Hypertension, hyperlipidemia, type 2 diabetes. Medications: Metformin 1000mg twice daily, Lisinopril 20mg daily, Atorvastatin 40mg daily. No known allergies. Last meal was lunch at 13:00.

History of Events

Timeline:
1415 hours: Patient was watching TV when he suddenly developed right-sided weakness and difficulty speaking
1416 hours: Patient attempted to stand, but fell back into the chair
1417 hours: Patient's wife called emergency services
1420 hours: Current time, patient is awake but confused, right-sided weakness and slurred speech continue

Prior Events: Patient reports no recent illnesses or injuries. Last medical check-up 6 months ago, routine follow-up. 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, facial droop)
- Time-sensitive condition requiring immediate medical evaluation and potential thrombolytic therapy
- Potential for rapid deterioration if left untreated

Differential Diagnoses:
1. Ischemic Stroke (high probability)
2. Hemorrhagic Stroke (less likely, but must be considered)
3. Transient Ischemic Attack (TIA) (possible, but symptoms are persistent)
4. Hypoglycemia (less likely given no history of insulin use, but must be checked)
5. Seizure (less likely given focal symptoms and no reported convulsions)

Required Actions:
- Dispatch of ground EMS with ALS capabilities
- Rapid transport to nearest stroke center
- Pre-notification of receiving hospital stroke team
- Initial assessment and stabilization of airway, breathing, circulation

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 left middle cerebral artery territory
- NIH Stroke Scale score upon arrival at hospital was 12
- Patient was eligible for and received intravenous thrombolysis within 45 minutes of hospital arrival

Outcome validated F2 priority assignment. Rapid dispatch and transport were crucial for timely treatment. Patient showed significant improvement following thrombolysis. 

Learning Points:
1. F2 classification appropriate due to time-sensitive nature of stroke symptoms
2. Initial assessment accurately identified the high probability of stroke
3. Prompt pre-hospital notification and hospital activation led to timely intervention and improved patient outcome

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller My husband, I think he is having a stroke! He can't move his right side and he's slurring his words.

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

Caller It's Hafnarstræti 96, apartment 3B, third floor in Akureyri.

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

Caller He was watching TV and suddenly his face drooped and he couldn't move his right arm and leg. He can't talk properly.

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 slurred. He looks very unwell.

Dispatcher Does he have any medical conditions?

Caller He has high blood pressure, high cholesterol, and diabetes. He takes medication for all of them.

Dispatcher Okay, the ambulance is on its way. Don't try to move him. Stay with him and keep him calm. I'm going to ask you a few more questions. Can you tell me his date of birth?

Caller He was born on the 12th of May 1978. Please hurry, I'm so worried.

Dispatcher Okay, the ambulance is on its way. We'll be there as quickly as possible.