Hlíðarvegur 14, 600 Akureyri, ground floor apartment 1B. Three-story residential building, built in 1995, concrete structure. Main entrance with a code lock. No elevator, access through a short ramp. Street parking available. Building has a basic fire alarm system. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6778° N, 18.0875° W. Nearest landmark: Akureyri Botanical Garden.
32-year-old female, 38 weeks pregnant, experiencing sudden onset of severe abdominal pain and vaginal bleeding. Patient reports contractions every 5 minutes, each lasting about 60 seconds. Patient is pale, anxious, and diaphoretic. First pregnancy. Medical history: No significant medical conditions. No known allergies. Last meal was a light lunch at 13:00. Patient is at home, lying on her side on the sofa.
Timeline: 1400 hours: Patient started experiencing mild abdominal cramping. 1415 hours: Cramping increased in intensity and frequency, becoming regular contractions. 1430 hours: Patient noticed vaginal bleeding, described as bright red and moderate. 1435 hours: Patient called her husband for help. He is on his way home. 1440 hours: Patient called emergency services. Current time. Patient is lying down on the sofa, experiencing severe pain. Prior Events: Routine prenatal care, no complications reported. Fetal movements have been normal until this episode. No recent illnesses or injuries. Last prenatal check-up was 3 days ago. Patient is full term, expected delivery in 2 weeks.
Initial Impression: Suspected Placental Abruption or Preterm Labor with Bleeding Justification for F2 Classification: - High probability of serious obstetric complication given the sudden onset of pain, contractions, and vaginal bleeding. - Potential for maternal and fetal compromise if not addressed promptly. - Time-sensitive condition requiring urgent medical evaluation and intervention. Differential Diagnoses: 1. Placental Abruption (high probability) 2. Preterm Labor with Bleeding (possible) 3. Cervical Ectropion Bleeding (less likely given severity of pain) 4. Vasa Previa (less likely but needs consideration) Required Actions: - Dispatch of ground EMS with ALS capabilities, including obstetric equipment - Rapid transport to the nearest hospital with obstetric services - Monitor maternal vital signs and fetal heart rate (if possible) - Preparation for potential emergency C-section