Emergency Scenario 700_f2

Location Information

Full Location:

Miðgarður 14, 700 Egilsstaðir, single-story detached house built in 1985. Main entrance at the front, no steps. Parking available in the driveway. No known security features. Current conditions: 8°C, overcast, good visibility, dry roads. GPS coordinates: 65.2633° N, 14.3922° W. Nearest landmark: Egilsstaðir Swimming Pool.

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 right-sided weakness and slurred speech. Patient is conscious but confused. Symptoms started approximately 30 minutes ago. Patient has a history of hypertension and type 2 diabetes. Medications include Metformin 500mg twice daily, Lisinopril 20mg daily, Atorvastatin 10mg daily. No known allergies. Last meal was lunch at 13:00.

History of Events

Timeline:
1400 hours: Patient was watching TV, felt a sudden weakness on his right side.
1405 hours: Patient attempted to stand, found it difficult, noticed slurred speech.
1410 hours: Patient called his wife for help, wife called emergency services.
1415 hours: Current time, patient is conscious but confused, still experiencing right-sided weakness and slurred speech.

Prior Events: Patient has been managing his diabetes and hypertension with medication for 5 years. No recent changes in medications. No recent illnesses or injuries. Last medical check-up 6 months ago, routine follow-up. Patient lives with his wife.

Diagnostics

Initial Assessment

Initial Impression: Suspected Acute Stroke
Justification for F2 Classification:
- Sudden onset of focal neurological deficits (right-sided weakness, slurred speech)
- Time-sensitive condition requiring rapid medical intervention to minimize neurological damage
- Risk of rapid deterioration requiring immediate medical evaluation and treatment

Differential Diagnoses:
1. Ischemic Stroke (most likely)
2. Transient Ischemic Attack (TIA) (possible, requires assessment to rule out)
3. Intracranial Hemorrhage (less likely, but possible)
4. Hypoglycemia (less likely, given no history of missed meals or insulin use)
5. Postictal state (less likely, no history of seizures)

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

Final Diagnosis

Final Diagnosis: Acute Ischemic Stroke (Left Middle Cerebral Artery)
Key Findings:
- CT scan of the brain confirmed a left middle cerebral artery (MCA) ischemic stroke.
- Patient's symptoms persisted and worsened slightly during transport. NIHSS score of 8 upon arrival at the hospital.
- Patient received thrombolytic therapy within the appropriate time window.

Outcome validated F2 priority assignment. Rapid dispatch and transport were crucial for potential treatment and improved outcomes. Patient was admitted to the stroke unit for further management.

Learning Points:
1. F2 classification was appropriate given the time-sensitive nature of stroke.
2. Initial assessment accurately identified the high likelihood of a stroke.
3. Pre-hospital FAST assessment and early hospital notification were critical.

Emergency Call Transcript

Dispatcher Emergency services, what is your emergency?

Caller My husband is acting strange, I think he is having a stroke!

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

Caller It's Miðgarður 14 in Egilsstaðir.

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

Caller He was watching TV and suddenly his right side got weak. He can't speak properly and he is confused.

Dispatcher Is he awake and talking to you?

Caller Yes, he is awake but very confused. He keeps slurring his words.

Dispatcher Does he have any medical conditions?

Caller He has high blood pressure and diabetes. He takes some pills for them.

Dispatcher Okay, the ambulance is on its way. Stay with him and keep him calm. Do not give him anything to eat or drink.

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