Emergency Scenario 700_f2

Location Information

Full Location:

Miðgarður 15, 700 Egilsstaðir. Single-story residential house built in 1985. Main entrance at ground level, no steps. One main entrance door. No security features. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.2667° N, 14.3992° W. Nearest landmark: Egilsstaðir Swimming Pool.

Municipality: Egilsstaðir

Postal Code: 700

Emergency Details

Type: Allergic Reaction

Priority Level: F2

Response Time Goal: Urgent (15-30 minutes)

Description:

45-year-old female experiencing severe allergic reaction after eating shellfish. Primary symptoms: Rapid onset of facial swelling, difficulty breathing, wheezing, and throat tightness. Secondary symptoms: Generalized itching, hives, dizziness. Patient is conscious but anxious. Medical history: Known allergy to shellfish, carries an EpiPen. Medications: None currently taken, patient self-administered EpiPen 5 minutes prior to call. Last meal was shellfish at 18:00.

History of Events

Timeline:
1800 hours: Patient consumed shellfish at home.
1815 hours: Initial symptoms of itching and hives developed.
1820 hours: Rapid progression of symptoms including facial swelling, throat tightness, and difficulty breathing.
1822 hours: Patient self-administered EpiPen.
1825 hours: Symptoms slightly improved after EpiPen, but difficulty breathing persists.
1827 hours: Patient calls emergency services.

Prior Events: Patient has a history of severe allergic reactions to shellfish, requiring emergency treatment in the past. Patient has an EpiPen at home and carries one with her at all times. No recent illnesses or injuries. Last medical check-up 6 months ago, routine follow-up.

Diagnostics

Initial Assessment

Initial Impression: Severe Anaphylactic Reaction
Justification for F2 Classification:
- Rapid onset of severe symptoms including airway compromise (throat tightness, difficulty breathing) after known allergen exposure.
- Potential for rapid deterioration without immediate medical intervention.
- Patient has self-administered EpiPen, indicating severe reaction.
- Time-sensitive condition requiring prompt medical evaluation and potential advanced airway management.

Differential Diagnoses:
1. Anaphylaxis (high probability)
2. Angioedema (likely component of anaphylaxis)
3. Acute Asthma Exacerbation (less likely given known shellfish allergy and rapid onset)
4. Upper Respiratory Infection (less likely given rapid onset and allergen exposure)

Required Actions:
- Dispatch of ground EMS with ALS capabilities
- Assessment of airway, breathing, and circulation
- Potential need for additional epinephrine, oxygen, and/or intubation
- Preparation for transport to nearest hospital with emergency department.

Final Diagnosis

Final Diagnosis: Severe Anaphylactic Reaction to Shellfish
Key Findings:
- Patient presented with classic symptoms of anaphylaxis: facial swelling, throat tightness, wheezing, hives, and difficulty breathing.
- Self-administered EpiPen provided temporary relief, but symptoms persisted.
- Physical exam revealed stridor and use of accessory muscles for breathing.
- Blood pressure was initially elevated due to stress and then dropped slightly.
- Oxygen saturation was low despite supplemental oxygen.
- Patient responded well to additional epinephrine and IV antihistamines during transport.

Outcome validated F2 priority assignment. Rapid dispatch and treatment were essential. Patient required close monitoring and further treatment in the hospital.

Learning Points:
1. F2 classification appropriate due to the need for rapid intervention and potential for airway compromise.
2. Initial assessment accurately identified the high likelihood of anaphylaxis based on history and symptoms.
3. Prompt epinephrine administration and airway management were critical for patient stabilization.

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller I'm having a really bad allergic reaction! I ate some shellfish and now I can't breathe well.

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

Caller It's Miðgarður 15 in Egilsstaðir.

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

Caller I ate shellfish about 20 minutes ago and now my face is swelling, my throat is tight, and I'm having trouble breathing.

Dispatcher Have you taken any medication or anything to help?

Caller Yes, I used my EpiPen about 5 minutes ago, but I'm still having trouble breathing.

Dispatcher Okay, the ambulance is on its way. Do you have any medical conditions?

Caller I'm allergic to shellfish, that's it.

Dispatcher Okay, try to stay calm and don't move too much. The ambulance will be there soon.

Caller Okay, thank you. I'll wait here.