Hafnarstræti 96, 600 Akureyri, third floor apartment 3B. Four-story concrete building, constructed in 1965. Main entrance has a keypad lock. Elevator and central stairwell available. Street parking only. Building has fire alarm system. Current conditions: 7°C, overcast, light wind, good visibility. GPS coordinates: 65.6821° N, 18.0923° W. Nearest landmark: Akureyri Art Museum.
45-year-old female, exhibiting acute psychotic symptoms. Primary symptoms: Agitation, paranoia, auditory hallucinations. Patient reports feeling 'watched' and hearing voices telling her to harm herself. Secondary symptoms: Increased heart rate, sweating, pacing. Patient is alert but disoriented. No known physical injuries. Patient is in her apartment. Medical history: Bipolar disorder, diagnosed 5 years ago. Medications: Lithium 400mg twice daily, Quetiapine 200mg at night. No known allergies. Last meal was a light lunch at 13:00. Patient has not been taking medications as prescribed for the past 3 days.
Timeline: 1400 hours: Patient became increasingly agitated, started pacing and talking to herself. 1415 hours: Patient reported hearing voices and expressed paranoid thoughts, feeling watched. 1430 hours: Patient threatened to harm herself and became increasingly distressed. 1440 hours: Patient's sister, Guðrún, called emergency services. 1445 hours: Current time, patient still agitated, pacing in her apartment. Prior Events: Patient has had several manic episodes in the past, requiring hospitalization. Last manic episode was 6 months ago. No recent changes in medication. Patient has been under stress due to work issues. Patient has missed several therapy appointments.
Initial Impression: Acute Psychotic Episode secondary to Bipolar Disorder Justification for F3 Classification: - Patient is experiencing acute psychiatric symptoms, including paranoia and hallucinations. - Patient has expressed suicidal ideation, but does not present an immediate threat. - Time-sensitive condition requiring psychiatric evaluation and stabilization, but not immediately life-threatening. Differential Diagnoses: 1. Acute Psychotic Episode secondary to Bipolar Disorder (high probability) 2. Substance-induced psychosis (less likely, no known substance use) 3. Schizophrenia (possible, but less likely given history of bipolar disorder) 4. Severe anxiety with panic attacks (less likely given reported hallucinations) Required Actions: - Dispatch of ground EMS with BLS capabilities and trained personnel for psychiatric emergencies. - Assessment of patient safety and risk of self-harm. - Stabilization of patient and transport to psychiatric facility.