Emergency Scenario 600_f2

Location Information

Full Location:

Hafnarstræti 18, 600 Akureyri, ground floor of a two-story commercial building. Constructed in 1955, concrete structure with large storefront windows. Main entrance is at street level, no steps. Side access through a back alley with a locked gate. No elevator. Street parking available. Building has a basic fire alarm system. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6827° N, 18.0895° W. Nearest landmark: Akureyri Art Museum.

Municipality: Akureyri

Postal Code: 600

Emergency Details

Type: Syncope - Unwitnessed Collapse

Priority Level: F2

Response Time Goal: Within 20 minutes

Description:

68-year-old male, found unresponsive in his office. Primary symptoms: Unresponsive, found lying on the floor, pale skin, shallow breathing. Secondary symptoms: No reported seizure activity, no visible injuries. Patient has a known history of heart disease, takes multiple medications. Caller is a colleague, found the patient during a routine check. Caller reports no witness to the collapse. Office is small, cluttered, with limited space. No AED available on site.

History of Events

Timeline:
1000 hours: Patient last seen by colleague, reported feeling unwell, complaining of lightheadedness.
1015 hours: Patient found unresponsive on the floor by colleague during a routine check.
1016 hours: Caller attempted to rouse patient, no response.
1017 hours: Caller immediately dialed emergency services.
1020 hours: Current time, patient still unresponsive, shallow breathing.

Prior Events: Patient has a history of coronary artery disease, diagnosed 5 years ago. Recent healthcare contact: Cardiology appointment 2 weeks ago, medication adjustment. Medications: Aspirin 75mg daily, Atorvastatin 20mg daily, Metoprolol 50mg twice daily, Ramipril 5mg daily. Allergies: Penicillin. Last oral intake: Coffee and a small pastry at 0900 hours.

Diagnostics

Initial Assessment

Initial Impression: Unresponsive Patient - Possible Cardiac Syncope
Justification for F2 Classification:
- Unresponsive patient with known cardiac history
- Potential for life-threatening underlying cause
- Requires prompt medical evaluation and intervention

Differential Diagnoses:
1. Cardiac Syncope (high probability given history)
2. Stroke/TIA (possible, requires assessment)
3. Hypoglycemia (less likely, no history of diabetes)
4. Seizure (no reported seizure activity)
5. Medication side effect (possible, requires review)

Required Actions:
- Dispatch of ground EMS with ALS capabilities
- Rapid assessment of ABCs (Airway, Breathing, Circulation)
- Cardiac monitoring and ECG
- Preparation for transport to nearest hospital with cardiac services

Final Diagnosis

Final Diagnosis: Ventricular Tachycardia Leading to Syncope
Key Findings:
- Initial ECG on arrival showed ventricular tachycardia
- Patient regained consciousness briefly after initial intervention
- Blood work confirmed no acute metabolic issues
- Cardiac assessment confirmed underlying cardiac arrhythmia as the cause of syncope

Outcome validated F2 priority assignment. Rapid dispatch and cardiac intervention were critical. Patient was stabilized and admitted for further cardiac management.

Learning Points:
1. F2 classification was appropriate due to the life-threatening potential of the condition.
2. Accurate initial assessment of unresponsiveness and cardiac history was crucial for rapid diagnosis and treatment.
3. Prompt cardiac monitoring and ECG are essential in cases of unexplained syncope.

Emergency Call Transcript

Dispatcher Emergency services, what is your emergency?

Caller I need an ambulance! My colleague is unconscious in his office.

Dispatcher Okay, I am sending help. What is the address?

Caller It's Hafnarstræti 18, in Akureyri. Ground floor office.

Dispatcher Can you tell me what happened?

Caller I found him on the floor. He's not responding. He was feeling unwell earlier, lightheaded.

Dispatcher Is he breathing?

Caller Yes, but it's shallow. He's pale. I tried to wake him up but he won't respond.

Dispatcher Does he have any known medical conditions?

Caller Yes, he has heart problems. He takes medications for it.

Dispatcher Okay, the ambulance is on its way. Stay with him and try to keep him still.

Caller Okay, I will. Thank you!