Emergency Scenario 700_f2

Location Information

Full Location:

Miðvangur 2, 700 Egilsstaðir. Single-story detached house, built in 1985. Main entrance on the north side, with a small porch. No security system. Gravel driveway. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.2667° N, 14.3952° W. Nearest landmark: Egilsstaðir Airport.

Municipality: Egilsstaðir

Postal Code: 700

Emergency Details

Type: Neurological Symptoms

Priority Level: F2

Response Time Goal: Urgent (15-30 minutes)

Description:

68-year-old male, sudden onset of left-sided weakness and slurred speech. Primary symptoms: Left arm and leg weakness, facial droop on the left side, difficulty speaking. Secondary symptoms: Dizziness, headache. Patient is conscious but confused. No recent trauma. Medical history: Hypertension, Type 2 Diabetes. Medications: Metformin 500mg twice daily, Lisinopril 10mg daily, Atorvastatin 20mg daily. No known allergies. Last meal was a light lunch at 13:00.

History of Events

Timeline:
1410 hours: Patient was watching TV when he suddenly experienced weakness in his left arm and leg.
1411 hours: Patient attempted to speak but had difficulty forming words. Noticed facial drooping.
1412 hours: Patient became dizzy and experienced a headache. Called his son for help.
1415 hours: Son arrived and called emergency services.
1417 hours: Current time, patient is conscious but confused, sitting on the sofa.

Prior Events: Patient has had hypertension and diabetes for 10 years, well controlled with medication. No recent illnesses or injuries. Last medical check-up 6 months ago, routine follow-up. Patient lives alone, son lives nearby.

Diagnostics

Initial Assessment

Initial Impression: Suspected Acute Stroke (Cerebrovascular Accident)
Justification for F2 Classification:
- Sudden onset of focal neurological deficits (left-sided weakness, slurred speech, facial droop)
- High probability of stroke based on presentation and risk factors
- Time-sensitive condition requiring rapid medical intervention

Differential Diagnoses:
1. Ischemic Stroke (high probability)
2. Hemorrhagic Stroke (less likely, but possible)
3. Transient Ischemic Attack (TIA) (possible, but symptoms persistent)
4. Hypoglycemia (less likely, no history of insulin use)
5. Seizure (less likely, no reported convulsions)

Required Actions:
- Dispatch of ground EMS with ALS capabilities
- Pre-hospital stroke assessment (FAST score)
- Rapid transport to nearest hospital with stroke center
- Early notification of hospital for stroke activation

Final Diagnosis

Final Diagnosis: Acute Ischemic Stroke, Left Middle Cerebral Artery (MCA) Territory
Key Findings:
- CT scan of the brain confirmed an acute ischemic stroke in the left MCA territory
- NIH Stroke Scale (NIHSS) score was 12, indicating moderate severity
- Patient received thrombolytic therapy (tPA) within 3 hours of symptom onset
- No evidence of hemorrhage on CT

Outcome validated F2 priority assignment. Rapid dispatch and early hospital notification were essential for time-sensitive treatment. Patient showed improvement after tPA administration. Patient required subsequent rehabilitation.

Learning Points:
1. F2 classification appropriate due to the need for timely intervention.
2. Initial assessment accurately identified the high likelihood of a stroke.
3. Early recognition and rapid transport to a stroke center are crucial for improved patient outcomes.

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller My father, he's not feeling well! He's having trouble speaking and can't move his left side properly.

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

Caller It's Miðvangur 2, in Egilsstaðir.

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

Caller He was just sitting watching TV, and then suddenly he couldn't move his left arm and leg. His speech is slurred, and his face looks droopy on one side.

Dispatcher Is he awake and talking to you?

Caller Yes, he's awake, but he's confused. He also says he has a headache and feels dizzy.

Dispatcher Does he have any medical conditions?

Caller Yes, he has high blood pressure and diabetes. He takes pills for them.

Dispatcher Okay, the ambulance is on its way. Please keep him calm and do not give him anything to eat or drink. We'll be there soon.

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