Emergency Scenario 700_f2

Location Information

Full Location:

Miðgarður 2, 700 Egilsstaðir, single-story detached house. Built in 1985. Main entrance is at the front of the house. No security features. Driveway access. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.2678° N, 14.3952° W. Nearest landmark: Egilsstaðir Airport.

Municipality: Egilsstaðir

Postal Code: 700

Emergency Details

Type: Obstetric Emergency

Priority Level: F2

Response Time Goal: Urgent (15-30 minutes)

Description:

28-year-old female, 38 weeks pregnant, experiencing sudden onset of severe abdominal pain and vaginal bleeding. Patient reports contractions starting 15 minutes ago, increasing in intensity and frequency. Patient is pale, anxious, and reports feeling lightheaded. Medical history: First pregnancy, no previous complications. No known allergies. No medications. Last meal was a light lunch at 12:00. Patient is at home.

History of Events

Timeline:
13:15 hours: Patient experienced a sudden sharp pain in abdomen
13:16 hours: Patient noticed vaginal bleeding
13:17 hours: Contractions started, described as strong and regular
13:20 hours: Patient called her husband who then called emergency services
13:22 hours: Current time, patient is still at home, experiencing severe pain and bleeding

Prior Events: Patient has had a normal pregnancy with regular check-ups. No previous complications or concerns. No recent illnesses or injuries. Last prenatal visit was 1 week ago. Patient lives with her husband.

Diagnostics

Initial Assessment

Initial Impression: Suspected Placental Abruption or Preterm Labor
Justification for F2 Classification:
- High probability of significant obstetric complication based on symptoms (severe pain, vaginal bleeding, contractions)
- Potential for rapid deterioration of maternal and fetal condition
- Time-sensitive condition requiring prompt medical evaluation and intervention

Differential Diagnoses:
1. Placental Abruption (high probability given bleeding and pain)
2. Preterm Labor (likely given contractions at 38 weeks)
3. Uterine Rupture (less likely but cannot be ruled out)
4. Vasa Previa (less likely given no prior history)

Required Actions:
- Dispatch of ground EMS with ALS capabilities
- Immediate transport to nearest hospital with obstetric services
- Monitoring of maternal vital signs and fetal heart rate (if possible)
- Preparation for potential delivery or surgical intervention

Final Diagnosis

Final Diagnosis: Placental Abruption with Preterm Labor
Key Findings:
- Ultrasound at hospital confirmed partial placental abruption
- Fetal heart rate monitoring showed signs of fetal distress
- Patient's condition deteriorated during transport, requiring immediate C-section

Outcome validated F2 priority assignment. Rapid dispatch and transport were critical. Emergency C-section was performed successfully, and both mother and baby are stable.

Learning Points:
1. F2 classification was appropriate due to the potential for rapid deterioration
2. Initial assessment correctly identified the high-risk nature of the situation
3. Prompt transport and hospital intervention were crucial for a positive outcome

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller My wife is pregnant and she's having a lot of pain and bleeding! I think something is wrong!

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

Caller It's Miðgarður 2 in Egilsstaðir.

Dispatcher Help is on its way. How far along is she in her pregnancy?

Caller She is 38 weeks pregnant. She started having bad pain about 15 minutes ago and she is bleeding.

Dispatcher Is she having contractions?

Caller Yes, they are very strong and coming often. She is pale and feels lightheaded.

Dispatcher Okay, the ambulance is on its way. Please stay with her, keep her calm and do not give her anything to eat or drink.

Caller Okay, thank you, I'll wait here with her. I'm very worried.