Emergency Scenario 700_f3

Location Information

Full Location:

Miðgarður 14, 700 Egilsstaðir. Single-story residential house with wooden construction, built in 1985. Main entrance at the front of the house, no security system. Street parking available. Weather conditions: 8°C, overcast, light winds. GPS coordinates: 65.2644° N, 14.3948° W. Nearest landmark: Egilsstaðir Swimming Pool.

Municipality: Egilsstaðir

Postal Code: 700

Emergency Details

Type: Psychiatric Emergency

Priority Level: F3

Response Time Goal: Standard (30-60 minutes)

Description:

35-year-old male, experiencing acute psychotic episode. Primary symptoms: Agitation, disorganized speech, paranoid delusions (believes neighbors are watching him), auditory hallucinations (hearing voices). Secondary symptoms: Increased heart rate, sweating, pacing. Patient is not considered a threat to himself or others currently. No known medical conditions or allergies. Medications: None reported. Last meal was a light snack at 18:00. Patient was last seen normal at 17:00 by his sister, Hildur, who is the caller.

History of Events

Timeline:
1700 hours: Patient was normal, had dinner with sister
1800 hours: Patient ate a light snack
1900 hours: Patient started exhibiting signs of agitation, talking to himself
1930 hours: Patient became increasingly paranoid, began pacing and speaking incoherently. Reports hearing voices
2000 hours: Sister called emergency services after patient refused to calm down. No history of previous psychiatric episodes. No recent changes in life circumstances reported. Patient does not have any known substance abuse issues. No recent travel.

Diagnostics

Initial Assessment

Initial Impression: Acute Psychotic Episode
Justification for F3 Classification:
- Patient exhibiting clear signs of psychosis (delusions, hallucinations, disorganized speech)
- No immediate threat to self or others reported by caller
- Condition requires evaluation and potential psychiatric intervention, but is not immediately life-threatening

Differential Diagnoses:
1. Acute Psychotic Episode (most likely)
2. Substance-Induced Psychosis (unlikely based on history)
3. Bipolar Disorder with Psychotic Features (possible, but no prior history)
4. Schizophrenia (possible, but no prior history)

Required Actions:
- Dispatch of ground EMS with appropriate psychiatric assessment capabilities
- Assessment of patient's mental state and risk of harm
- Safe transport to psychiatric facility for evaluation and treatment

Final Diagnosis

Final Diagnosis: Acute Psychotic Episode, likely secondary to undiagnosed Schizophrenia
Key Findings:
- Detailed psychiatric assessment at the hospital confirmed the presence of disorganized thoughts, paranoid delusions, and auditory hallucinations
- Patient reported having similar but milder episodes in the past which he had not sought treatment for
- No evidence of substance use was found
- Patient responded well to initial antipsychotic medication

Outcome: F3 priority was appropriate given the absence of immediate life threat. Early intervention prevented escalation of symptoms. Patient was admitted for further assessment and treatment.

Learning Points:
1. Initial assessment accurately identified the psychotic nature of the emergency.
2. F3 classification was appropriate, given no immediate danger.
3. Follow-up assessment revealed likely undiagnosed Schizophrenia.

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller My brother is acting very strangely, I think he might be having some kind of breakdown.

Dispatcher Okay, can you tell me your address?

Caller Yes, it's Miðgarður 14 in Egilsstaðir.

Dispatcher Alright, help is on its way. What exactly is your brother doing?

Caller He's pacing around the house, talking to himself, and he says the neighbors are watching him. He keeps saying he hears voices too. It's really scaring me.

Dispatcher Is he a threat to himself or others?

Caller No, he's not being violent, just very agitated and confused. He's never acted like this before. He was fine earlier today.

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

Caller No, not that I know of. He doesn't take any medication. He ate a small snack a couple of hours ago, but that's it.

Dispatcher Okay, an ambulance is on its way. Try to keep him calm and stay safe. Do not engage him if you feel unsafe.

Caller Okay, I will. Thank you.