Hafnarstræti 2, 400 Ísafjörður, first floor apartment 1B. Three-story wooden residential building constructed in 1955. Main entrance has a simple lock. One internal stairwell. Street parking available. Building has no fire alarm system. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 66.0742° N, 23.1281° W. Nearest landmark: Ísafjörður harbor.
65-year-old male, experiencing severe shortness of breath. Primary symptoms: Rapid, shallow breathing, audible wheezing, cyanosis around lips, and chest tightness. Patient is conscious but appears anxious and struggling to breathe. Secondary symptoms: Mild cough, reports feeling dizzy. Patient sitting upright on the edge of his bed. Medical history: COPD diagnosed 5 years ago, history of smoking, mild hypertension. Medications: Salbutamol inhaler (as needed), Tiotropium inhaler (daily), Amlodipine 5mg daily. No known allergies. Last meal was a light lunch at 13:00.
Timeline: 14:30 hours: Patient began experiencing mild shortness of breath. 14:45 hours: Symptoms worsened rapidly, with increased wheezing and difficulty breathing. 14:50 hours: Patient's wife called emergency services. 14:52 hours: Current time, patient is still struggling to breathe and cyanotic around the lips. Prior Events: Patient reports having a mild cold last week, but no recent exacerbations of COPD. He has been using his salbutamol inhaler more frequently in the past 24 hours. Last medical check-up was 6 months ago, routine follow-up. Patient lives with his wife.
Initial Impression: Acute Exacerbation of COPD with Respiratory Distress Justification for F2 Classification: - Severe respiratory distress with signs of hypoxia (cyanosis) - Rapid onset of symptoms and significant breathing difficulty - History of COPD, making this a high-risk situation - Time-sensitive condition requiring prompt medical intervention Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pneumonia (possible, less likely given lack of fever) 3. Pulmonary Embolism (less likely, no history of DVT or recent surgery) 4. Acute Heart Failure (less likely, no prior history of heart failure) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration and bronchodilator therapy - Continuous monitoring of vital signs and oxygen saturation - Preparation for transport to nearest hospital with respiratory support