Heiðarvegur 14, 900 Vestmannaeyjar. Two-story residential house, built in 1985, wooden frame construction. Main entrance at street level, no elevator. Driveway access. No security system. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 63.4409° N, 20.2691° W. Nearest landmark: Vestmannaeyjar Golf Club.
35-year-old male, exhibiting acute agitation and paranoia. Patient is pacing and shouting, claiming he is being watched and his phone is bugged. Patient has a history of bipolar disorder, last manic episode six months ago. Currently refusing medication. No known allergies. Last meal was a small snack at 14:00. Patient is alone in his home.
Timeline: 1600 hours: Patient began exhibiting restlessness and pacing. 1615 hours: Patient started making paranoid statements, claiming surveillance. 1630 hours: Patient refused to take his prescribed medication. 1645 hours: Caller, patient's sister, arrived at the house after being contacted by the patient's neighbour who was concerned by the shouting and agitation. Patient is still agitated, refusing to talk to his sister and pacing in the living room. 1650 hours: Current time, sister called emergency services. Prior Events: Patient diagnosed with bipolar disorder 5 years ago. History of medication non-compliance. Last mental health follow-up appointment was 3 months ago, missed last appointment. No recent hospitalizations for psychiatric reasons, last episode six months ago.
Initial Impression: Acute Manic Episode with Paranoia Justification for F3 Classification: - Patient is exhibiting symptoms of a manic episode, including agitation and paranoia, which are not immediately life-threatening but require timely intervention. - Patient is refusing medication, indicating a need for professional psychiatric assessment and potential intervention. - No immediate safety concerns are reported, but the situation could escalate without intervention. Response time is within the standard range for non-life-threatening but time-sensitive situations. Differential Diagnoses: 1. Acute Manic Episode (most likely) 2. Psychotic Disorder (less likely, no prior diagnosis) 3. Substance-Induced Psychosis (possible, no history of substance abuse reported) 4. Acute Anxiety Disorder (less likely given paranoia and agitation) Required Actions: - Dispatch of ground EMS with BLS capabilities. - Communication with psychiatric emergency team for further guidance and consultation. - Assessment of patient's mental status and safety upon arrival. - Safe transport to psychiatric evaluation facility if required.