Hafnarstræti 91, 600 Akureyri, third-floor apartment 3B. A five-story reinforced concrete building, built in 1985. The main entrance has a keypad lock. Elevator and central stairwell access. Street parking is available, but can be limited during peak hours. The building has a fire alarm system. Current conditions: 8°C, overcast, light wind, good visibility. GPS coordinates: 65.6832° N, 18.0925° W. Nearest landmark: Akureyri Art Museum.
35-year-old male, exhibiting acute agitation and paranoia. Primary symptoms: Expressing delusional beliefs, pacing, shouting, refusing to cooperate. Secondary symptoms: Increased heart rate, sweating, dilated pupils. Patient is known to have a history of bipolar disorder but has been non-compliant with medication. No known allergies. Last meal was a sandwich at 14:00. No known recent drug or alcohol use reported by caller. Patient is in his apartment.
Timeline: 1600 hours: Patient began pacing and muttering, became increasingly agitated. 1615 hours: Patient started expressing paranoid delusions, shouting about being watched. 1620 hours: Caller (patient's brother) arrived at the apartment after receiving a concerning phone call. 1625 hours: Patient refused attempts at calming, continued to escalate in agitation. 1630 hours: Caller contacted emergency services. Prior Events: Patient diagnosed with bipolar disorder 5 years ago, previously managed with medication. Patient has a history of medication non-compliance and prior psychiatric hospitalizations. Last psychiatric appointment was 6 months ago. No recent physical illnesses or injuries reported. Patient lives alone, but brother visits regularly.
Initial Impression: Acute Manic Episode with Possible Psychotic Features Justification for F3 Classification: - Patient exhibiting symptoms of a psychiatric emergency requiring assessment and intervention. - While not immediately life-threatening, the potential for self-harm or harm to others exists. - Time-sensitive condition requiring a timely response to prevent escalation and ensure patient safety. Differential Diagnoses: 1. Manic Episode with Psychotic Features (most likely) 2. Acute Psychotic Disorder (less likely given history) 3. Substance-Induced Psychosis (less likely based on caller report) 4. Agitation secondary to a medical condition (less likely given history and presentation) Required Actions: - Dispatch of ground EMS with personnel trained in psychiatric emergencies. - Assessment of patient's mental status and risk of harm. - De-escalation techniques if possible, safe transport to psychiatric facility.