Maija is out shopping at a shopping centre with her friend Sirpa. The friends have been going from store to store, and Maija has picked out a beautiful new dress. When in line for the toilets at the shopping centre, Maija suddenly loses consciousness. Sirpa sees Maija collapse. Her body turns stiff and her limbs and muscles start to contract uncontrollably.
Maija does have epilepsy, Sirpa recalls, taking a quick look at her wrist watch.
Sirpa has taken first aid classes, and this isn’t the first time she’s seen Maija have a seizure. She knows what to do in such a situation. Sirpa places her hands around Maija’s head to prevent her from banging her head on the floor or otherwise hurting herself.
A crowd starts to gather around Maija and Sirpa. " There’s nothing to worry about. I’m sure she’ll be fine in a moment”, Sirpa tries to calm them down. At that moment, Sirpa remembers a conversation they had in the cafe. Maija had said she’d had a seizure in the morning just as her boyfriend Lasse was heading off to work. It had lasted only a few minutes and Maija had been able to recover quickly. " I’m glad it passed so quickly. Otherwise Lasse would probably have been late for work, because he’s always leaving at the last minute”, Maija had said laughing.
A call to the emergency number
Time seems to stand still. Sirpa twists her arm a little so she can see her watch. The seizure has now gone on for about three minutes.
This is the second seizure Maija has had on the same day, and her convulsions don’t seem to be easing up. Best to call the emergency number, thinks Sirpa.
“Can I be of help in some way?” asks a shopping centre security guard who has just arrived on the scene. Sirpa’s handbag is on the floor. Sirpa asks the security guard to hand her the phone in her bag. She ponders asking the guard to call the emergency response centre, but decides to do it herself, because she knows more about Maija’s situation. “Thanks”, says Sirpa, unwrapping one of her hands from around Maija’s head in order to grasp the phone.
Sirpa opens the 112 Suomi app she had previously downloaded and calls the emergency response centre. The emergency dispatcher picks up almost immediately. Sirpa uses the speaker phone function to talk so she can use both of her hands to protect the head of Maija, who is still in convulsions.
Sirpa briefly narrates the events and gives a precise address to the location, even though the dispatcher can also use the GPS geolocation function of the 112 Suomi app to see the exact position of her phone.
The dispatcher conducts a risk assessment based on the information given in the phone call. Using the VIRVE authority radio network, they dispatch an advanced level EMS unit, assigning the situation a B urgency class. After the dispatch, they instruct Sirpa on how to proceed.
An EMS unit is on the way to your location. Continue to protect your friend’s head with your hands and arms. Is there anybody nearby who could go to the main entrance of the shopping centre to wait for the EMS to arrive and to guide them to the location?
The security guard heads for the main entrance to wait for the emergency personnel. It seems Maija’s convulsions are abating. The dispatcher says that if the convulsions stop, Maija should be placed lying on her side and her unimpeded breathing ensured. Finally, the dispatcher says Sirpa should call again if there are any changes in the situation. Sirpa is permitted to hang up the call.
The EMS nurses arrive
Soon after the call ends, Maija’s seizure stops. Drawing on her first aid training, Sirpa places Maija lying on her side and makes sure her airway is open so she can breathe freely.
Maija is now on the floor on her side and breathing steadily. Sirpa tries to get Maija to answer how she’s feeling. Maija is still groggy and won’t answer questions. Sirpa hears steps approaching at a quick pace. From behind a corner, two emergency nurses emerge, escorted by the security guard.
Hey, I’m Jaakko, a paramedic. Can you tell me what’s happened?” the emergency nurse asks, setting down his backpack full of first aid supplies.
Sirpa fills him in on Maija’s illness and the day’s events. Jaakko asks about Maija’s personal information. Sirpa remembers Maija carries an identity card in her wallet and hands it to Jaakko. The second paramedic, who says her name is Kaisa, examines Maija’s condition. Maija’s blood oxygen content, blood pressure, and blood sugar are measured.
Maija is now starting to come to, but she has no recollection of what just happened. She is told she had a convulsive seizure. Maija, clearly exhausted, is nonetheless able to answer the paramedics’ questions coherently.
She fills the paramedics in on her medication and the seizure she had at home that morning. Jaakko makes careful notes about the event, the questioning, and the examination, creating an emergency medical care report. The paramedics follow the recommended course of treatment. They suggest Maija should be transported to the local emergency room for further care and observation, since she has already had two seizures on the same day. Maija agrees. It is good to take a more careful look at the situation.
Kaisa leaves for the ambulance to pick up a transportation stretcher. In the meantime, Jaakko asks Sirpa for her contact information and appends it to the emergency care report in case the duty physician wants to ask for more details about Maija’s seizure at a later time.
Kaisa returns with the stretcher and the paramedics pick up Maija. “Sirpa, can you tell Lasse they’ve taken me to the emergency room?” Maija asks her friend. Maija says goodbye to her friend and the paramedics thank Sirpa for her exemplary actions and the first aid she gave.
On the way to the emergency department
In the ambulance, Kaisa, the paramedic, opens up the medical supply bag and seems to be preparing for a procedure of some kind.
I am going to insert a cannula into the vein in the back of your hand. Through that, we can give you medication if more convulsions happen”, says Kaisa the paramedic.
The cannula insertion does not feel very painful despite Maija’s fears. Maija can hear the paramedic call in to the emergency response centre to report the unit’s transportation code, its occupancy level, and the destination for Maija’s continued treatment. Because Maija’s condition is stable, the ambulance does not need to use its sirens and light during the transport. Nevertheless, Kaisa monitor’s Maija’s status during the journey. Maija remains tired, but feels she is doing much better already.
Soon the ambulance pulls in to the hospital’s ambulance bay. Maija is carried into the emergency room on the stretcher. Almost immediately, a nurse from the emergency department meets Maija and the paramedics. “Hello, Maija, my name is Merja, and I am a nurse”, says the friendly nurse, dressed in blue scrubs. An assessment of Maija’s need for care and its urgency is conducted, and her data is logged into the emergency department’s patient information system. The nurse ties a patient bracelet around Maija’s wrist.
The paramedics take Maija to the emergency department’s observation room and help her move onto the hospital bed. The paramedics provide the observation nurse with an exact report on the seizure and Maija’s current condition. The paramedics bid Maija a good day.
Thank you for all your help”, says Maija, thankful.
The paramedics leave, taking their stretcher. “How do you feel now?” asks the observation room’s nurse, Ulla, while placing an oxygen saturation gauge onto Maija’s fingertip. Maija’s treatment has shifted from the prehospital to the hospital setting.