Hafnarstræti 23, 600 Akureyri, third-floor apartment 3B. A four-story mixed-use building constructed in 1965 with concrete and wood frame. The main entrance has a key code. One elevator and central stairwell. Street parking is available. The building has a fire alarm system. Current conditions: 7°C, overcast, light wind, moderate visibility. GPS coordinates: 65.6816° N, 18.0912° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, found unresponsive at home. Primary symptoms: Unresponsive, agonal breathing, cyanosis. Secondary symptoms: None reported by caller. Patient found lying on living room floor. Medical history: COPD diagnosed 5 years ago, hypertension, previous MI 2 years ago. Medications: Salbutamol inhaler (as needed), Tiotropium inhaler daily, Amlodipine 10mg daily, Aspirin 75mg daily. Known allergy to penicillin. Last meal was a light lunch at 13:00.
Timeline: 1600 hours: Patient was last seen by his wife, reported feeling slightly unwell, mild shortness of breath. 1630 hours: Wife returned home and found patient unresponsive on the living room floor. 1632 hours: Wife called emergency services. 1635 hours: Current time, patient remains unresponsive with agonal breathing. Prior Events: Patient has had several COPD exacerbations in the past year, requiring hospital admissions. Last medical check-up 2 months ago, routine follow-up. Patient lives with his wife, who is now the caller.
Initial Impression: Respiratory Failure secondary to COPD exacerbation, cardiac arrest possible. Justification for F1 Classification: - Unresponsive patient with agonal breathing, indicating imminent respiratory or cardiac arrest. - Cyanosis suggests severe hypoxia, requiring immediate intervention. - History of COPD and previous MI increases risk of rapid deterioration. - Time-critical situation requiring immediate dispatch of ALS unit. Differential Diagnoses: 1. Acute COPD exacerbation with respiratory failure (high probability) 2. Cardiac arrest secondary to MI (possible) 3. Pulmonary embolism (less likely but must be considered) 4. Severe pneumonia (less likely given rapid onset) 5. Drug overdose (unlikely, no history of drug abuse) Required Actions: - Dispatch of ground EMS with ALS capabilities. - Immediate notification of receiving hospital for potential critical care admission. - Initiate CPR instructions to caller if patient becomes apneic. - Preparation for intubation and mechanical ventilation.