Emergency Scenario 600_f3

Location Information

Full Location:

Hafnarstræti 23, 600 Akureyri, third floor apartment 3B. A three-story wooden apartment building built in 1950. Main entrance has a simple lock; no intercom. Stairwell access only, no elevator. Street parking available. Building is not equipped with a fire alarm system. Current conditions: 8°C, clear skies, good visibility. GPS coordinates: 65.6825° N, 18.0912° W. Nearest landmark: Akureyri Art Museum.

Municipality: Akureyri

Postal Code: 600

Emergency Details

Type: Pediatric Respiratory Distress

Priority Level: F3

Response Time Goal: Standard (30-60 minutes)

Description:

A 4-year-old male child is experiencing difficulty breathing. Primary symptoms include rapid breathing, audible wheezing, and mild retractions. The child is alert but appears anxious and is restless. Secondary symptoms: Mild cough, no fever reported. Child is sitting upright on a chair. Medical history: Previous history of asthma, uses a salbutamol inhaler as needed. No known allergies. Last oral intake was a snack at 15:00.

History of Events

Timeline:
1600 hours: Child started coughing mildly.
1610 hours: Cough worsened, child began to wheeze.
1615 hours: Child's breathing became rapid and labored.
1620 hours: Mother called emergency services.
1622 hours: Current time, child is still wheezing and having difficulty breathing.

Prior Events: Child has had several similar episodes in the past, all managed at home with salbutamol. Last asthma exacerbation was two months ago. No recent illnesses or injuries. Last medical check-up was 6 months ago, routine pediatric visit. Child attends a local preschool.

Diagnostics

Initial Assessment

Initial Impression: Moderate Asthma Exacerbation
Justification for F3 Classification:
- Child is experiencing respiratory distress, but is alert and responsive
- Symptoms are concerning but not immediately life-threatening
- Condition requires medical intervention but is not an F1 or F2 emergency

Differential Diagnoses:
1. Asthma Exacerbation (most likely)
2. Bronchiolitis (less likely given age and history)
3. Upper Respiratory Infection (possible contributing factor)
4. Foreign Body Aspiration (less likely given lack of sudden onset and choking)

Required Actions:
- Dispatch of ground EMS with basic life support capabilities
- Assessment of respiratory status and oxygen saturation
- Administration of salbutamol via inhaler if available and as needed
- Monitoring for signs of deterioration

Final Diagnosis

Final Diagnosis: Moderate Asthma Exacerbation
Key Findings:
- Physical exam confirmed wheezing, tachypnea, and mild retractions
- Oxygen saturation was 94% on room air
- Child responded well to initial salbutamol administration
- No signs of infection or foreign body aspiration were noted

Outcome validated F3 priority assignment. The child's condition improved with prompt medical attention and salbutamol administration. Patient was transported to the hospital for further evaluation and monitoring.

Learning Points:
1. F3 classification was appropriate given the patient's stable but concerning condition.
2. Dispatch instructions to use salbutamol were appropriate and effective.
3. Accurate assessment of respiratory distress is critical in pediatric cases.

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller My son is having trouble breathing! He's wheezing really badly.

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

Caller It's Hafnarstræti 23, apartment 3B, third floor in Akureyri.

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

Caller He started coughing earlier, and now he's wheezing. It's hard for him to breathe.

Dispatcher How old is your son?

Caller He's four years old.

Dispatcher Does he have any medical conditions?

Caller Yes, he has asthma. He has an inhaler, but I'm not sure if I should use it.

Dispatcher Yes, if you have his salbutamol inhaler, please use it now. The ambulance is on its way.

Caller Okay, I will do that right now. Thank you.