Emergency Scenario 600_f2

Location Information

Full Location:

Hafnarstræti 18, 600 Akureyri, ground floor of a two-story wooden building constructed in 1935. Main entrance is street level, no steps. No elevator. Street parking available. Building is a former shop now used as a small office. Current conditions: 8°C, clear skies, good visibility. GPS coordinates: 65.6837° N, 18.0919° 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:

55-year-old male, collapsed at his office. Primary symptoms: Unresponsive, witnessed collapse, shallow breathing. Secondary symptoms: Pale skin, no reported chest pain. Patient found lying on the floor. Medical history: Type 2 diabetes, hypertension, previous episode of syncope 2 years ago. Medications: Metformin 1000mg twice daily, Lisinopril 20mg daily. No known allergies. Last meal was a sandwich at 12:00.

History of Events

Timeline:
1310 hours: Patient was working at his desk, no complaints reported.
1312 hours: Patient suddenly collapsed to the floor, witnessed by a colleague.
1313 hours: Colleague called emergency services after determining unresponsiveness.
1315 hours: Current time, patient still unresponsive, breathing shallow.

Prior Events: Patient reported feeling slightly lightheaded earlier in the day but attributed it to not eating lunch. No recent illnesses or injuries. Last medical check-up 6 months ago, routine follow-up for diabetes and hypertension. Patient lives alone.

Diagnostics

Initial Assessment

Initial Impression: Unresponsive - Suspected Syncope with Potential Cardiac Involvement
Justification for F2 Classification:
- Patient unresponsive following a witnessed collapse
- Potential for underlying cardiac or neurological cause
- Requires urgent medical evaluation and intervention

Differential Diagnoses:
1. Vasovagal Syncope (possible, but unresponsiveness is concerning)
2. Cardiac Arrhythmia (high suspicion due to collapse)
3. Hypoglycemia (possible given diabetic history)
4. Stroke/TIA (less likely given sudden onset and lack of focal deficits)
5. Seizure (less likely given lack of tonic-clonic activity)

Required Actions:
- Dispatch of ground EMS with ALS capabilities
- Continuous monitoring of airway, breathing, and circulation
- Blood glucose check if possible
- Preparation for potential advanced airway management and cardiac support

Final Diagnosis

Final Diagnosis: Cardiac Arrhythmia - Ventricular Tachycardia
Key Findings:
- ECG on arrival showed Ventricular Tachycardia
- Patient regained consciousness briefly with defibrillation
- Blood glucose was within normal range
- No other underlying causes identified

Outcome validated F2 priority assignment. Rapid dispatch and ALS intervention were crucial for patient survival. Patient was admitted to the cardiac care unit for further management.

Learning Points:
1. F2 classification appropriate due to the need for rapid assessment and potential life-threatening arrhythmia
2. Initial assessment correctly identified the need for advanced cardiac support
3. Prompt defibrillation was essential in restoring normal rhythm

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller My colleague just collapsed! He's not responding.

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

Caller It's Hafnarstræti 18, Akureyri. It's a small office on the ground floor.

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

Caller He was working at his desk and then just fell to the floor. He's not waking up. He's breathing but it's shallow.

Dispatcher Is he completely unresponsive?

Caller Yes, he's not responding to me at all. His skin is pale.

Dispatcher Does he have any medical conditions that you know of?

Caller Yes, he has diabetes and high blood pressure. I think he had an episode like this before a few years ago.

Dispatcher Okay, the ambulance is on its way. Don't try to move him. Stay with him and check his breathing.

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