Emergency Scenario 735_f3

Location Information

Full Location:

Hafnargata 18, 735 Norðfjörður, Ground floor of a two-story wooden house built in 1965. Main entrance faces the street. No security features. Street parking available. Current conditions: 8°C, clear skies, good visibility. GPS coordinates: 65.2074° N, 14.2169° W. Nearest landmark: The local harbor.

Municipality: Norðfjörður

Postal Code: 735

Emergency Details

Type: Gastrointestinal Emergency

Priority Level: F3

Response Time Goal: Standard (30-60 minutes)

Description:

68-year-old female, experiencing severe abdominal pain, nausea, and vomiting. Primary symptoms: Abdominal pain described as sharp and constant, located in the lower abdomen, nausea, and three episodes of vomiting in the last hour. Secondary symptoms: Weakness and dizziness. Patient is alert and oriented but appears distressed. Skin is pale and clammy. Patient is sitting on the sofa in her living room. Medical history: Type 2 diabetes, hypertension, and a previous episode of diverticulitis 2 years ago. Medications: Metformin 500mg twice daily, Lisinopril 10mg daily, and Atorvastatin 20mg daily. No known allergies. Last meal was a light lunch at 13:00.

History of Events

Timeline:
1400 hours: Patient began experiencing mild abdominal discomfort.
1430 hours: Abdominal pain increased in intensity, accompanied by nausea.
1500 hours: First episode of vomiting. Two more episodes followed in the next 15 minutes.
1515 hours: Patient felt weak and dizzy. Called emergency services.
1520 hours: Current time, patient is still experiencing severe pain and nausea.

Prior Events: Patient has had no recent illnesses or injuries. Last medical check-up was 6 months ago, routine follow-up. She lives alone and is generally healthy.

Diagnostics

Initial Assessment

Initial Impression: Suspected Diverticulitis or Gastroenteritis
Justification for F3 Classification:
- Significant abdominal pain, nausea, and vomiting, indicating a non-life-threatening but time-sensitive condition.
- History of diverticulitis makes it a likely differential.
- Patient is stable but requires medical evaluation and pain management.

Differential Diagnoses:
1. Diverticulitis (likely given past history)
2. Gastroenteritis (possible given symptoms)
3. Bowel Obstruction (less likely given lack of distension and constipation)
4. Appendicitis (less likely given location of pain)

Required Actions:
- Dispatch of ground EMS with BLS capabilities
- Pain management protocols initiation
- Evaluation for dehydration and electrolyte imbalances
- Preparation for transport to nearest hospital for further assessment and treatment

Final Diagnosis

Final Diagnosis: Acute Diverticulitis
Key Findings:
- Physical examination revealed tenderness in the lower left quadrant of the abdomen.
- Blood tests showed elevated white blood cell count and inflammatory markers.
- CT scan confirmed inflammation of the diverticula in the sigmoid colon.

Outcome validated F3 priority assignment. The patient required intravenous antibiotics and pain management. Patient recovered well after a few days of treatment in the hospital.

Learning Points:
1. F3 classification was appropriate given the need for timely, but not immediate, intervention.
2. Initial assessment correctly identified the high likelihood of diverticulitis.
3. Early diagnosis and treatment were crucial in preventing complications

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller I'm having terrible stomach pain and I've been throwing up. I need help.

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

Caller It's Hafnargata 18, in Norðfjörður.

Dispatcher Help is on its way. Can you describe the pain?

Caller It's a sharp pain in my lower abdomen, it won't stop. I feel so sick.

Dispatcher Have you vomited?

Caller Yes, three times in the last hour. I feel so weak.

Dispatcher Do you have any medical conditions?

Caller I have diabetes and high blood pressure. I had diverticulitis a couple of years ago.

Dispatcher Okay, the ambulance is on its way. Don't try to eat or drink anything. Stay calm and wait for them.

Caller Okay, thank you. I'll wait here.