Emergency Scenario 900_f2

Location Information

Full Location:

Miðbær 17, 900 Vestmannaeyjar. Two-story residential house, built in 1965, concrete structure. Main entrance on the ground floor, no elevator. Street parking available. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 63.4418° N, 20.2738° W. Nearest landmark: Landakirkja church.

Municipality: Vestmannaeyjar

Postal Code: 900

Emergency Details

Type: Obstetric Emergency

Priority Level: F2

Response Time Goal: Within 30 minutes

Description:

32-year-old female, 38 weeks pregnant, reports sudden onset of severe abdominal pain and vaginal bleeding. Patient is conscious and alert but distressed. Primary symptoms: severe abdominal pain, bright red vaginal bleeding, contractions every 5 minutes. Secondary symptoms: dizziness, nausea. Patient is at home in her living room. Medical history: Previous uncomplicated pregnancy, no known allergies. Medications: Prenatal vitamins. Last meal was a light lunch at 13:00.

History of Events

Timeline:
1430 hours: Patient reports sudden onset of severe abdominal pain
1435 hours: Patient reports onset of vaginal bleeding
1438 hours: Patient reports contractions starting
1440 hours: Patient calls emergency services
1442 hours: Current time, patient still experiencing pain, bleeding, and contractions

Prior Events: Patient had a routine check-up yesterday, everything was normal. No prior complications in this pregnancy. No recent falls or trauma. Patient has been feeling well until the sudden onset of symptoms.

Diagnostics

Initial Assessment

Initial Impression: Suspected Placental Abruption
Justification for F2 Classification:
- High probability of serious obstetric complication based on presenting symptoms
- Significant vaginal bleeding, severe abdominal pain, and contractions indicate a potential threat to both mother and fetus
- Time-sensitive condition requiring prompt medical evaluation and possible intervention

Differential Diagnoses:
1. Placental Abruption (high probability)
2. Preterm Labor (less likely given the severity of pain and bleeding)
3. Placenta Previa (less likely given pain presentation)
4. Uterine Rupture (less likely given no history of previous uterine surgery)

Required Actions:
- Dispatch of ground EMS with ALS capabilities
- Rapid transport to nearest hospital with obstetric services
- Monitoring of maternal and fetal vital signs
- Preparation for potential emergency C-section

Final Diagnosis

Final Diagnosis: Confirmed Placental Abruption
Key Findings:
- Ultrasound confirmed placental abruption with significant retroplacental hemorrhage
- Patient's pain score remained high despite initial analgesia
- Fetal heart rate initially normal, later showed signs of distress
- Patient underwent emergency C-section

Outcome validated F2 priority assignment. Rapid dispatch and transport were critical for maternal and fetal outcomes. Patient and baby are stable post-surgery.

Learning Points:
1. F2 classification appropriate due to the need for timely obstetric intervention
2. Initial assessment accurately identified the high likelihood of placental abruption
3. Prompt transport and surgical intervention were essential for positive outcomes

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller I'm pregnant and I'm bleeding! I have terrible pain.

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

Caller It's Miðbær 17, in Vestmannaeyjar.

Dispatcher Help is on its way. How far along are you in your pregnancy?

Caller I'm 38 weeks pregnant. The pain is so bad, and I'm bleeding a lot.

Dispatcher Can you describe the pain?

Caller It's like a constant, sharp pain in my belly. I think I'm having contractions too, every few minutes.

Dispatcher Are you feeling dizzy or nauseous?

Caller Yes, a bit dizzy and nauseous. Please hurry!

Dispatcher Okay, the ambulance is on its way. Stay calm and try to relax. Don't try to move around too much.

Caller Okay, thank you. I will wait here.