Emergency Scenario 640_f2

Location Information

Full Location:

Garðarsbraut 17, 640 Húsavík, single-story residential house built in 1985. Main entrance is on the street level. No stairs at entrance. Street parking available. House equipped with smoke detectors. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 66.0464° N, 17.3363° W. Nearest landmark: Húsavík Church.

Municipality: Húsavík

Postal Code: 640

Emergency Details

Type: Neurological Symptoms

Priority Level: F2

Response Time Goal: Urgent (15-30 minutes)

Description:

65-year-old male, sudden onset of right-sided weakness and slurred speech. Primary symptoms: Right arm and leg weakness, difficulty speaking. Secondary symptoms: Facial droop on the right side, mild confusion. Patient is conscious but appears distressed. Medical history: Hypertension, type 2 diabetes. Medications: Metformin 1000mg twice daily, Lisinopril 20mg daily. No known allergies. Last meal was a light lunch at 13:00.

History of Events

Timeline:
1400 hours: Patient was watching TV, felt sudden weakness on right side
1402 hours: Patient attempted to stand, but right leg gave way
1403 hours: Patient experienced difficulty speaking, slurred speech
1405 hours: Wife (caller) noticed symptoms and called emergency services
1408 hours: Current time, patient sitting in a chair, unable to move right side

Prior Events: Patient reports no recent falls or injuries. Last medical check-up 6 months ago, routine follow-up. No recent illnesses. Patient lives with his wife.

Diagnostics

Initial Assessment

Initial Impression: Suspected Acute Stroke
Justification for F2 Classification:
- Rapid onset of focal neurological deficits (weakness, speech difficulty, facial droop)
- High suspicion of stroke based on symptoms
- Time-sensitive condition requiring immediate medical intervention

Differential Diagnoses:
1. Ischemic Stroke (most likely given presentation)
2. Hemorrhagic Stroke (possibility given hypertension)
3. Transient Ischemic Attack (TIA) (less likely due to symptom severity and persistence)
4. Hypoglycemia (less likely given patient history and no sweating)

Required Actions:
- Dispatch of ground EMS with ALS capabilities
- Pre-notification of hospital stroke team
- Rapid transport to nearest hospital with stroke services
- Monitoring of neurological status during transport

Final Diagnosis

Final Diagnosis: Acute Ischemic Stroke (Right Middle Cerebral Artery)
Key Findings:
- CT scan of the brain confirmed an acute ischemic stroke in the territory of the right middle cerebral artery.
- Patient's symptoms were consistent with a right-sided MCA stroke.
- No evidence of hemorrhage on CT scan.

Outcome validated F2 priority assignment. Rapid dispatch and transport were crucial for potential thrombolytic therapy. Patient was admitted to the stroke unit for ongoing care and rehabilitation.

Learning Points:
1. F2 classification was appropriate given the time-critical nature of stroke.
2. Initial assessment accurately identified the high likelihood of stroke.
3. Early recognition of stroke symptoms is essential for optimal patient outcomes.

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller My husband, I think he's having a stroke! He can't move his right side and his speech is slurred.

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

Caller It's Garðarsbraut 17 in Húsavík.

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

Caller He was watching TV and suddenly he got weak on his right side. He tried to get up but his leg gave way. Now he can barely talk.

Dispatcher Is he awake and can he understand you?

Caller Yes, he's awake but he seems confused. He's trying to talk but it's hard to understand him.

Dispatcher Does he have any medical conditions?

Caller Yes, he has high blood pressure and diabetes. He takes medication for both.

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

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