Emergency Scenario 735_f2

Location Information

Full Location:

Hafnarbraut 14, 735 Norðfjörður, ground floor apartment. Two-story wooden residential building constructed in 1955. Main entrance at street level, no steps. No elevator. Street parking available. Building has basic fire alarm system. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.1987° N, 14.2185° W. Nearest landmark: Norðfjörður harbor.

Municipality: Norðfjörður

Postal Code: 735

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. Patient alert but confused. Secondary symptoms: Mild headache, dizziness. Patient sitting in a chair in his living room. Medical history: Hypertension, Type 2 diabetes. Medications: Metformin 500mg twice daily, Lisinopril 10mg daily, Atorvastatin 20mg daily. No known allergies. Last meal was lunch at 13:00.

History of Events

Timeline:
1445 hours: Patient was watching TV, suddenly felt weakness in left arm
1446 hours: Patient attempted to stand, noticed left leg was also weak
1447 hours: Patient noticed difficulty speaking, slurred words
1448 hours: Patient called his son for help
1450 hours: Son arrived, called emergency services
1452 hours: Current time, patient sitting in a chair, unable to move left side

Prior Events: Patient had a similar episode of transient weakness 2 years ago which resolved spontaneously. No recent falls 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
Justification for F2 Classification:
- Sudden onset of focal neurological deficits, suggestive of stroke
- Left-sided weakness, facial droop, and slurred speech are classic stroke symptoms
- Time-sensitive condition requiring prompt medical intervention to minimize brain damage

Differential Diagnoses:
1. Ischemic Stroke (high probability)
2. Transient Ischemic Attack (TIA) (possible, but symptoms persistent)
3. Intracranial Hemorrhage (less likely, no severe headache or loss of consciousness)
4. Hypoglycemia (less likely, patient is diabetic but not reported to be insulin-dependent)
5. Seizure (less likely, no reported convulsions)

Required Actions:
- Dispatch of ground EMS with ALS capabilities
- Rapid transport to nearest stroke center
- Pre-notification of hospital for potential thrombolysis
- Assessment of blood glucose level

Final Diagnosis

Final Diagnosis: Acute Ischemic Stroke
Key Findings:
- CT scan of the brain confirmed an acute ischemic stroke in the right middle cerebral artery territory
- Patient's NIH Stroke Scale score was 12 upon arrival at the hospital
- Blood glucose was within normal range
- No evidence of hemorrhage

Outcome validated F2 priority assignment. Rapid dispatch and transport were crucial for timely thrombolysis. Patient received tPA within the appropriate window, resulting in significant improvement in neurological deficits.

Learning Points:
1. F2 classification appropriate due to the need for rapid intervention in suspected stroke
2. Initial assessment accurately identified the high likelihood of a stroke
3. Pre-hospital stroke assessment tools should be used to expedite hospital notification and treatment

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller My father is sick! He can't move his left side and he is slurring his words.

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

Caller It's Hafnarbraut 14, in Norðfjörður. Ground floor apartment.

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

Caller He was watching TV, and then he suddenly couldn't move his left arm. Then his leg got weak too and he started talking funny.

Dispatcher Is he awake and talking to you?

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