Emergency Scenario 700_f3

Location Information

Full Location:

Miðgarður 15, 700 Egilsstaðir. Single-story residential house built in 1985. Main entrance with two steps. Gravel driveway. No security features. Current conditions: 8°C, overcast, light wind, good visibility. GPS coordinates: 65.2667° N, 14.3974° W. Nearest landmark: Egilsstaðir Swimming Pool.

Municipality: Egilsstaðir

Postal Code: 700

Emergency Details

Type: Gastrointestinal Emergency

Priority Level: F3

Response Time Goal: Standard (30-60 minutes)

Description:

62-year-old male, experiencing severe abdominal pain, nausea, and vomiting for the past 3 hours. Primary symptoms: Severe, cramping abdominal pain, localized in the epigastric region, frequent vomiting (4 times) of partially digested food, nausea, diaphoresis. Secondary symptoms: General weakness, dizziness, reported feeling slightly feverish. Patient is alert and oriented but visibly distressed. Medical history: History of peptic ulcers, managed with antacids, no known allergies, no recent surgeries. Medications: Omeprazole 20mg daily, occasional use of paracetamol for pain. Last meal was a light lunch at 13:00.

History of Events

Timeline:
16:00 hours: Patient experienced mild epigastric discomfort.
16:30 hours: Pain intensified, nausea started.
17:00 hours: First episode of vomiting, partially digested food.
17:30 hours: Three more episodes of vomiting, continued severe pain, diaphoresis.
18:00 hours: Current time, patient called emergency services. Patient is sitting on the sofa, pale and sweating.

Prior Events: Patient has a history of peptic ulcers and occasional episodes of heartburn. No recent changes in medication or diet. No recent travel or exposure to sick individuals. Last medical check-up 6 months ago for routine follow-up.

Diagnostics

Initial Assessment

Initial Impression: Suspected Acute Gastroenteritis/Peptic Ulcer Exacerbation
Justification for F3 Classification:
- Significant abdominal pain and vomiting, indicating a gastrointestinal issue.
- Patient is alert and oriented, no signs of hemodynamic instability.
- Condition is not immediately life-threatening but requires timely medical evaluation and pain management.

Differential Diagnoses:
1. Acute Gastroenteritis (most likely due to symptoms and duration)
2. Peptic Ulcer Exacerbation (given past history)
3. Food Poisoning (possible but less likely given the history)
4. Pancreatitis (less likely given the lack of severe back pain)
5. Bowel Obstruction (less likely given the lack of severe distension)

Required Actions:
- Dispatch of ground EMS with BLS capabilities
- Assessment of vital signs
- Pain management protocols initiation
- Preparation for transport to nearest hospital for evaluation and treatment

Final Diagnosis

Final Diagnosis: Acute Gastroenteritis with Dehydration
Key Findings:
- Physical examination revealed mild dehydration, tachycardia, and epigastric tenderness.
- No signs of peritonitis or other acute abdominal pathology.
- Blood tests showed mild electrolyte imbalance, consistent with dehydration.
- Patient responded well to intravenous fluids and antiemetics.

Outcome validated F3 priority assignment. The patient's condition improved with supportive care. No surgical intervention was needed.

Learning Points:
1. F3 classification appropriate due to the need for timely assessment but not immediate life-threatening condition
2. Initial assessment accurately identified the most likely diagnosis
3. Hydration and antiemetics were the key interventions for this patient.

Emergency Call Transcript

Dispatcher Emergency services, what is your emergency?

Caller I need help, I'm in terrible pain in my stomach and I've been throwing up a lot.

Dispatcher Okay, I'm sending help. Can you tell me your address?

Caller It's Miðgarður 15 in Egilsstaðir.

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

Caller I started feeling bad a few hours ago, with pain and nausea, then I started vomiting. It's getting worse.

Dispatcher How many times have you vomited?

Caller Four times, I think. It's mostly food. I feel weak and dizzy.

Dispatcher Do you have any medical conditions?

Caller I have a history of stomach ulcers, I take Omeprazole for it.

Dispatcher Okay, the ambulance is on its way. Try to stay calm and sit down. Don't eat or drink anything.

Caller Okay, thank you. I will wait here.