Hafnarstræti 18, 600 Akureyri, ground floor of a two-story commercial building. Built in 1955, concrete structure with large storefront windows. Main entrance faces Hafnarstræti, no rear access. No elevators, one internal staircase to the second floor. Street parking available, limited space. Building has a basic alarm system. Current conditions: 8°C, overcast, light wind. GPS coordinates: 65.6828° N, 18.0925° W. Nearest landmark: Eymundsson bookstore.
56-year-old male, found unresponsive in a store. Primary symptoms: Loss of consciousness, patient briefly regained consciousness, now unresponsive again, witnessed fall, no seizure activity noted. Secondary symptoms: Pale skin, slow and weak pulse, shallow breathing. No reported chest pain. Medical history: History of hypertension, currently taking medication. No known allergies. Medications: Lisinopril 20mg daily, Amlodipine 5mg daily. Last meal was a sandwich at 11:00. No recent illness reported.
Timeline: 1215 hours: Patient was browsing in the store, appeared normal 1217 hours: Patient suddenly collapsed, hitting his head on a display shelf 1218 hours: Patient regained consciousness briefly, was confused, then lost consciousness again 1219 hours: Caller, a store employee, called emergency services 1220 hours: Current time, patient unresponsive, shallow breathing, pale skin Prior Events: Patient reports occasional lightheadedness in the past few months, but no prior episodes of syncope. Last medical check-up was 6 months ago, routine follow-up. No recent changes in medication. Patient has no known family history of cardiac issues.
Initial Impression: Syncope with Possible Cardiac Etiology Justification for F2 Classification: - Loss of consciousness, with a witnessed fall, raises concern for potential cardiac or neurological cause - Patient's pale skin, slow pulse, and shallow breathing indicate possible hemodynamic instability - Time-sensitive condition requiring prompt medical evaluation and intervention Differential Diagnoses: 1. Cardiac Syncope (arrhythmia, bradycardia, etc.) 2. Vasovagal Syncope (less likely given prolonged loss of consciousness) 3. Orthostatic Hypotension (possible, but needs further assessment) 4. Seizure (less likely given no reported seizure activity) 5. Hypoglycemia (possible, requires blood glucose check) Required Actions: - Dispatch of ground EMS with ALS capabilities - Continuous cardiac monitoring - Oxygen administration if indicated - Blood glucose check - Preparation for transport to nearest hospital with cardiac services