Emergency Scenario 600_f2

Location Information

Full Location:

Hlíðarvegur 22, 600 Akureyri, single-family home. Two-story wooden house built in 1995. Main entrance with two steps. Gravel driveway. No security features. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6728° N, 18.0941° W. Nearest landmark: Glerárkirkja Church.

Municipality: Akureyri

Postal Code: 600

Emergency Details

Type: Obstetric Emergency

Priority Level: F2

Response Time Goal: Urgent (15-30 minutes)

Description:

32-year-old female, 38 weeks pregnant, experiencing sudden onset of severe abdominal pain and vaginal bleeding. Patient reports contractions are 3 minutes apart, lasting 60 seconds. Patient is pale, anxious, and reports feeling dizzy. No previous pregnancies. No known allergies. Current medications: prenatal vitamins only. Last meal was a light lunch at 13:00. Initial assessment indicates a potential placental abruption.

History of Events

Timeline:
1430 hours: Patient reports sudden onset of severe abdominal pain.
1432 hours: Onset of vaginal bleeding and contractions.
1435 hours: Patient reports dizziness and increased anxiety.
1437 hours: Patient's husband called emergency services.
1440 hours: Current time, patient is in significant pain and bleeding continues.

Prior Events: Patient reports an uncomplicated pregnancy until now. No previous medical conditions. No history of trauma or falls. Regular prenatal check-ups. Last check-up 1 week ago, all normal.

Diagnostics

Initial Assessment

Initial Impression: Suspected Placental Abruption
Justification for F2 Classification:
- High probability of a serious obstetric complication based on presentation
- Patient experiencing severe pain, vaginal bleeding, and contractions at 38 weeks
- Potential for rapid deterioration of both mother and fetus
- Time-sensitive condition requiring immediate medical evaluation and intervention

Differential Diagnoses:
1. Placental Abruption (high probability)
2. Preterm Labor (less likely given severe pain and bleeding)
3. Placenta Previa (less likely given pain profile)
4. Uterine Rupture (lower probability, no history of prior uterine surgery)

Required Actions:
- Dispatch of ground EMS with ALS capabilities
- Rapid transport to the nearest hospital with obstetric services
- Continuous fetal monitoring during transport
- Preparation for potential emergency C-section

Final Diagnosis

Final Diagnosis: Confirmed Placental Abruption with Fetal Distress
Key Findings:
- Ultrasound at hospital confirmed a significant placental abruption
- Fetal heart rate monitoring indicated fetal distress
- Patient's vital signs showed signs of hypovolemia
- Emergency C-section was performed immediately

Outcome validated F2 priority assignment. Rapid transport and immediate intervention were critical for both maternal and fetal survival. Mother and baby recovered well after the emergency C-section.

Learning Points:
1. F2 classification was appropriate due to the high risk nature of the presentation.
2. Initial assessment accurately identified the high likelihood of placental abruption.
3. Rapid transport and hospital preparation were critical for a positive outcome.

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller My wife is pregnant and she's bleeding! She's in a lot of pain!

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

Caller It's Hlíðarvegur 22, Akureyri.

Dispatcher Help is on its way. How far along is your wife in her pregnancy?

Caller She's 38 weeks pregnant. The pain started suddenly, and she's bleeding. She says she feels dizzy.

Dispatcher Are the contractions regular?

Caller Yes, they are about every three minutes and they last about a minute. She's very pale and scared.

Dispatcher Okay, the ambulance is on its way. Stay calm and try to keep her comfortable. Don't give her anything to eat or drink.

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