Heiðarvegur 2, 900 Vestmannaeyjar. Single-story residential house built in 1965. Main entrance via front door with a small porch. No stairs to access. Street parking available. House is located on a quiet residential street. Current conditions: 8°C, overcast, light breeze, good visibility. GPS coordinates: 63.4419° N, 20.2731° W. Nearest landmark: Vestmannaeyjar Golf Club.
45-year-old male, exhibiting acute psychotic symptoms. Primary symptoms: Agitation, paranoia, auditory hallucinations. Patient reports feeling watched and threatened, believes neighbors are conspiring against him. Secondary symptoms: Increased heart rate, rapid speech, pacing. Patient is in his living room, alone. Medical history: Diagnosed with paranoid schizophrenia 10 years ago, non-compliant with medication for the past month. Medications: Previously on Risperidone 4mg daily, but not taking it currently. No known allergies. Last meal was a sandwich at 14:00.
Timeline: 1600 hours: Patient started exhibiting increased agitation and pacing. 1615 hours: Patient reported hearing voices and became increasingly paranoid. 1630 hours: Patient called his sister, Guðrún, expressing fear and paranoia. 1635 hours: Guðrún arrived at the house, found him agitated and delusional. 1640 hours: Guðrún called emergency services. 1642 hours: Current time, patient is pacing, agitated and speaking rapidly. Prior Events: Patient has a history of non-compliance with medication. He has had several similar episodes in the past, typically resolving with medication adjustments. Last psychiatric appointment was 3 months ago, follow-up appointment was missed due to non-compliance. No recent physical illnesses or injuries. Lives alone, sister lives nearby and is his primary support person.
Initial Impression: Acute Psychotic Episode Secondary to Schizophrenia Justification for F3 Classification: - Patient exhibiting active psychotic symptoms (paranoia, hallucinations, agitation) - History of schizophrenia and medication non-compliance - Condition is time-sensitive but not immediately life-threatening - Requires psychiatric evaluation and medication management Differential Diagnoses: 1. Acute Psychotic Episode (most likely) 2. Substance-Induced Psychosis (unlikely given history, no reported substance use) 3. Bipolar Disorder with Psychotic Features (less likely given chronic schizophrenia diagnosis) 4. Medical Condition Mimicking Psychosis (less likely, no reported fever, infection or injury) Required Actions: - Dispatch of ground EMS with basic life support capabilities - Safe transport to a psychiatric facility for evaluation - Assessment for potential risk of harm to self or others - De-escalation techniques if patient becomes more agitated