Emergency Scenario 900_f2

Location Information

Full Location:

Heiðarvegur 15, 900 Vestmannaeyjar, single-story residential house built in 1968. Main entrance is at the front, with a small porch. No steps to enter. Parking available on the street. No security features. Current conditions: 8°C, overcast, light winds. GPS coordinates: 63.4418° N, 20.2729° W. Nearest landmark: Vestmannaeyjar Golf Club.

Municipality: Vestmannaeyjar

Postal Code: 900

Emergency Details

Type: Acute Abdominal Pain

Priority Level: F2

Response Time Goal: Within 20 minutes

Description:

45-year-old male, experiencing severe abdominal pain. Primary symptoms: Sudden onset of sharp, constant pain in the lower right abdomen, rated 8/10 on pain scale. Secondary symptoms: Nausea, vomiting, and mild fever (38.0°C). Patient reports feeling weak and sweaty. Patient is conscious and alert but in distress. Patient lying on the sofa in the living room. Medical history: Appendectomy 10 years ago, no other significant medical history. Medications: None. No known allergies. Last meal was a light lunch at 13:00.

History of Events

Timeline:
1500 hours: Patient felt a mild discomfort in his abdomen
1530 hours: Pain intensified, becoming sharp and constant
1545 hours: Patient experienced nausea and vomited once
1550 hours: Patient developed a mild fever and felt weak
1555 hours: Patient called emergency services
1600 hours: Current time, patient still on sofa, in severe pain

Prior Events: Patient reports no recent illnesses or injuries. No recent travel. No known exposure to infectious diseases. Patient is generally healthy and active. Last medical check-up was 2 years ago, routine physical.

Diagnostics

Initial Assessment

Initial Impression: Suspected Acute Appendicitis
Justification for F2 Classification:
- High probability of an acute abdominal condition based on location and severity of pain
- Presence of fever, nausea, and vomiting
- Potential for rapid deterioration requiring prompt medical intervention

Differential Diagnoses:
1. Acute Appendicitis (high probability)
2. Renal Colic (less likely due to location of pain)
3. Gastroenteritis (less likely due to localized pain and high intensity)
4. Diverticulitis (less likely in this age group)

Required Actions:
- Dispatch of ground EMS with ALS capabilities
- Pain management protocols initiation
- Assessment for signs of sepsis
- Preparation for transport to nearest hospital with surgical services

Final Diagnosis

Final Diagnosis: Acute Appendicitis with Perforation
Key Findings:
- CT scan confirmed a perforated appendix with localized peritonitis
- Patient's pain score remained high despite initial analgesia
- Patient developed signs of tachycardia and hypotension during transport

Outcome validated F2 priority assignment. Rapid dispatch and pain management were essential. Patient underwent emergency appendectomy and received IV antibiotics.

Learning Points:
1. F2 classification appropriate due to the need for timely intervention
2. Initial assessment accurately identified the high likelihood of an acute abdominal pathology
3. Progression to perforation highlights the importance of early recognition and transport for acute appendicitis

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller I have a terrible pain in my stomach! It's really bad.

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

Caller It's Heiðarvegur 15, in Vestmannaeyjar.

Dispatcher Help is on its way. Can you tell me where the pain is?

Caller It's in my lower right side. It's sharp and constant. I feel like I'm going to throw up.

Dispatcher Have you vomited?

Caller Yes, once. And I feel hot, like I have a fever.

Dispatcher Do you have any medical conditions?

Caller I had my appendix out a long time ago, that's all.

Dispatcher Okay, the ambulance is on its way. Try to stay calm and don't eat or drink anything. We'll be there soon.

Caller Okay, thank you. I'm in so much pain, I can barely move.