Emergency Scenario 400_f3

Location Information

Full Location:

Hafnarstræti 17, 400 Ísafjörður, third floor apartment 3B. Four-story concrete building, constructed in 1965. Main entrance with intercom system. One elevator and central stairwell. Street parking available. Building equipped with fire alarm system. Current conditions: 7°C, overcast, moderate visibility. GPS coordinates: 66.0746° N, 23.1253° W. Nearest landmark: Ísafjörður harbor.

Municipality: Ísafjörður

Postal Code: 400

Emergency Details

Type: Psychiatric Emergency

Priority Level: F3

Response Time Goal: Standard (30-60 minutes)

Description:

45-year-old female, experiencing acute anxiety and paranoia. Primary symptoms: Agitation, pacing, expressing fear of being watched, auditory hallucinations (reporting hearing voices). Secondary symptoms: Sweating, rapid heart rate, hyperventilation. Patient is alert but distressed. No known medical history, but reports feeling increasingly anxious for the past week. Patient is currently alone in her apartment. No known drug or alcohol use.

History of Events

Timeline:
1000 hours: Patient reports feeling anxious and restless, started pacing.
1015 hours: Patient reports hearing voices, became increasingly agitated.
1020 hours: Patient expresses paranoid thoughts, feeling like she is being watched.
1025 hours: Patient called her sister for help, who then called emergency services.
1030 hours: Current time, patient is still pacing, reporting ongoing hallucinations and paranoia.

Prior Events: Patient reports a recent increase in stress due to work-related issues. No prior history of psychiatric illness. Last medical check-up was 6 months ago for routine examination. No recent hospitalizations or medical treatments.

Diagnostics

Initial Assessment

Initial Impression: Acute Anxiety Disorder with Possible Psychotic Features
Justification for F3 Classification:
- Patient is experiencing significant distress and agitation but is not currently a threat to self or others.
- Symptoms are not immediately life-threatening but require timely intervention to prevent escalation.
- Time-sensitive condition requiring psychiatric evaluation and support.

Differential Diagnoses:
1. Acute Anxiety Disorder with Psychotic Features (most likely)
2. Brief Psychotic Disorder (possible)
3. Substance-Induced Psychosis (less likely, no history of drug use)
4. Bipolar Disorder (less likely, no prior history)

Required Actions:
- Dispatch of ground EMS with BLS capabilities
- Initial assessment and calming techniques
- Transport to nearest hospital with psychiatric services
- Consider psychiatric consultation upon arrival at the hospital

Final Diagnosis

Final Diagnosis: Acute Anxiety Disorder with Psychotic Symptoms
Key Findings:
- Psychiatric evaluation confirmed severe anxiety and paranoia.
- Patient responded positively to calming techniques and anxiolytic medication.
- No evidence of substance use or underlying medical condition contributing to symptoms.
- No indication of suicidal or homicidal ideation.

Outcome validated F3 priority assignment. Timely intervention prevented further escalation. Patient was admitted for further observation and treatment. 

Learning Points:
1. F3 classification appropriate due to the need for timely psychiatric intervention
2. Initial assessment accurately identified the need for psychiatric support
3. Calming techniques and medication were effective in reducing patient's distress

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller My sister is having a panic attack, I think. She's really scared and saying strange things.

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

Caller It's Hafnarstræti 17, apartment 3B, third floor in Ísafjörður.

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

Caller She's pacing around, saying she hears voices and that people are watching her. She's very agitated.

Dispatcher Is she awake and talking to you?

Caller Yes, she's awake, but she's very scared and upset. She's sweating and breathing fast.

Dispatcher Does she have any medical conditions or take any medications?

Caller Not that I know of. She's been stressed lately with work, but nothing like this before.

Dispatcher Okay, the ambulance is on its way. Can you stay with her until they arrive?

Caller I'm not there, I called from my house, she's alone in her apartment. I will try to call her again.

Dispatcher Okay, please try to keep her calm and tell her help is coming. We will contact her as well.