Emergency Scenario 900_f3

Location Information

Full Location:

Heiðarvegur 14, 900 Vestmannaeyjar, single-story residential home. Built in 1985, wood construction with a concrete foundation. Main entrance on the north side, accessible via a short walkway. No security features. Current conditions: 8°C, overcast, light wind, good visibility. GPS coordinates: 63.4417° N, 20.2694° W. Nearest landmark: Vestmannaeyjar Golf Club.

Municipality: Vestmannaeyjar

Postal Code: 900

Emergency Details

Type: Pediatric - Respiratory Distress

Priority Level: F3

Response Time Goal: Standard (30-60 minutes)

Description:

3-year-old male child, experiencing acute respiratory distress. Primary symptoms: Rapid breathing, wheezing, and nasal flaring. Secondary symptoms: Mild fever (38.2°C), slight cough. Child is alert but agitated. Skin is pale with mild cyanosis around the mouth. Child is sitting upright, refusing to lie down. Medical history: History of asthma, previous hospitalization for bronchiolitis. Medications: Salbutamol inhaler (as needed), no current regular medications. No known allergies. Last meal was a small snack at 16:00.

History of Events

Timeline:
1700 hours: Child started coughing
1715 hours: Noticed increased breathing rate and wheezing
1720 hours: Child became more agitated, pale, and had nasal flaring
1725 hours: Caller contacted emergency services
1727 hours: Current time, child still experiencing respiratory distress

Prior Events: Child has had several mild respiratory infections in the past year. Last asthma exacerbation was 6 months ago, managed at home with salbutamol. No recent travel or exposure to new allergens. Last medical check-up 2 months ago, routine follow-up.

Diagnostics

Initial Assessment

Initial Impression: Acute Asthma Exacerbation/Bronchiolitis
Justification for F3 Classification:
- Respiratory distress with wheezing and nasal flaring, but child is still alert
- History of asthma and previous respiratory issues
- Time-sensitive condition requiring medical intervention, but not immediately life-threatening

Differential Diagnoses:
1. Acute Asthma Exacerbation (most likely given history)
2. Bronchiolitis (possible, especially with fever)
3. Foreign Body Aspiration (less likely, no choking reported)
4. Upper Respiratory Infection (possible, but symptoms suggest lower airway involvement)

Required Actions:
- Dispatch of ground EMS with BLS capabilities
- Respiratory support protocols initiation
- Assessment of oxygen saturation
- Preparation for transport to the nearest medical facility

Final Diagnosis

Final Diagnosis: Acute Bronchiolitis
Key Findings:
- Physical examination revealed diffuse wheezing and crackles
- Oxygen saturation was 92% on room air
- Chest X-ray showed hyperinflation and peribronchial thickening
- Viral swab confirmed RSV

Outcome validated F3 priority assignment. Child responded well to oxygen therapy and nebulized bronchodilators. Admitted for observation and respiratory support.

Learning Points:
1. F3 classification was appropriate due to the need for timely but not immediate intervention
2. Initial assessment accurately identified the respiratory distress, although the specific diagnosis was refined after further assessment
3. Dispatch protocols should emphasize assessment of respiratory status and potential for rapid deterioration in pediatric patients

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller My son is having trouble breathing! He's only three years old.

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

Caller It's Heiðarvegur 14, in Vestmannaeyjar.

Dispatcher Help is on its way. Can you tell me what's happening?

Caller He's breathing really fast, and he's wheezing. He seems pale and his nose is flaring out. He's also got a little fever.

Dispatcher Has he had problems like this before?

Caller Yes, he has asthma. He was hospitalized for bronchiolitis once before. He uses an inhaler when he needs it.

Dispatcher Okay, the ambulance is on its way. Do you have his inhaler?

Caller Yes, I do. I've given him a puff but it doesn't seem to help much.

Dispatcher Okay, don't give him any more. Stay with him and try to keep him calm until help arrives.

Caller Okay, thank you. I will wait here with him.