Emergency Scenario 600_f2

Location Information

Full Location:

Hafnarstræti 23, 600 Akureyri. Ground floor of a two-story commercial building, built in 1965, with large glass storefront windows. Main entrance on Hafnarstræti. No elevators. Street parking available. Building has a basic alarm system. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6811° N, 18.0902° W. Nearest landmark: Akureyri Art Museum.

Municipality: Akureyri

Postal Code: 600

Emergency Details

Type: Syncope/Collapse - Unresponsive

Priority Level: F2

Response Time Goal: Within 20 minutes

Description:

65-year-old male, collapsed in a shop. Primary symptoms: Unresponsive, witnessed collapse, shallow breathing. Secondary symptoms: Pale skin, weak pulse. No known medical history provided by the caller. Caller reports patient was standing and suddenly fell. Patient is currently lying on the floor of the shop. No obvious injuries observed. Bystanders are present but appear unsure how to help.

History of Events

Timeline:
1000 hours: Patient was browsing in the shop, appeared normal
1003 hours: Patient suddenly collapsed to the floor, no warning signs observed
1004 hours: Bystanders attempted to rouse the patient, no response
1005 hours: Caller (shop employee) called emergency services
1007 hours: Current time, patient remains unresponsive, shallow breathing

Prior Events: Caller unaware of any prior medical history or recent events. Patient was not a regular customer. No known allergies or medications. Last meal intake unknown.

Diagnostics

Initial Assessment

Initial Impression: Syncope with Possible Underlying Cause
Justification for F2 Classification:
- Unresponsiveness and shallow breathing indicate a potentially life-threatening situation
- Requires prompt medical assessment and intervention to determine the cause
- Risk of airway compromise and cardiac arrest if underlying cause is not addressed

Differential Diagnoses:
1. Cardiac Arrhythmia (high probability given sudden collapse)
2. Vasovagal Syncope (possible, but unresponsiveness is concerning)
3. Stroke (possible, but no focal neurological signs reported)
4. Hypoglycemia (less likely without known diabetes history)
5. Seizure (possible, no reported convulsive activity)

Required Actions:
- Dispatch of ground EMS with ALS capabilities
- Immediate airway assessment and management
- Continuous vital sign monitoring
- Preparation for transport to nearest hospital with cardiac capabilities

Final Diagnosis

Final Diagnosis: Ventricular Tachycardia with Syncope
Key Findings:
- ECG confirmed ventricular tachycardia upon arrival of EMS
- Patient regained consciousness briefly with oxygen and IV access
- Patient reported no chest pain or other pre-syncopal symptoms
- Blood glucose was normal

Outcome validated F2 priority assignment. Rapid dispatch and ALS intervention were crucial. Patient required cardioversion and was transported to the hospital for further cardiac evaluation and treatment.

Learning Points:
1. F2 classification was appropriate given the potential for rapid deterioration
2. ECG was critical in determining the underlying cause of the syncope
3. Initial assessment of unresponsiveness and shallow breathing were key indicators of the severity of the condition

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller A man just collapsed in my shop! He's not waking up!

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

Caller It's Hafnarstræti 23, in Akureyri.

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

Caller He was just standing here, then he fell to the ground. He's not moving. I don't know what to do.

Dispatcher Is he breathing?

Caller Yes, but it's very shallow, not normal. He's pale. I can't wake him up.

Dispatcher Do you know if he has any medical conditions?

Caller No, I don't know him. He's not a regular customer. I don't know anything about him.

Dispatcher Okay, the ambulance is on its way. Stay with him and don't move him. If his breathing stops, call us back immediately.

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