Hafnargata 15, 465 Bíldudalur. A two-story wooden house built in 1950. Main entrance facing the street. No elevator. One staircase. Street parking available. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6789° N, 23.5345° W. Nearest landmark: Bíldudalur harbor.
75-year-old male, experiencing severe shortness of breath. Primary symptoms: Difficulty breathing, wheezing, rapid shallow respirations, cyanosis around the lips. Secondary symptoms: Increased heart rate, chest tightness, anxiety. Patient is conscious but agitated. Patient is sitting upright in a chair. Medical history: COPD diagnosed 5 years ago, hypertension. Medications: Salbutamol inhaler (as needed), Fluticasone inhaler (twice daily), Lisinopril 10mg daily. Known allergy to penicillin. Last meal was a light lunch at 13:00. No recent illness.
Timeline: 1400 hours: Patient began experiencing mild shortness of breath. 1415 hours: Symptoms worsened, patient used Salbutamol inhaler without relief. 1420 hours: Patient's breathing became increasingly difficult, cyanosis noted. 1425 hours: Caller, patient's wife, called emergency services. 1428 hours: Current time, patient is struggling to breathe, very anxious. Prior Events: Patient has had several COPD exacerbations in the past, requiring hospital admission. Last hospital admission 6 months ago. No recent changes in medications. Patient uses oxygen at home occasionally but not currently.
Initial Impression: Acute Exacerbation of COPD with Respiratory Distress Justification for F2 Classification: - Significant respiratory distress with cyanosis, indicating severe hypoxia. - Patient's history of COPD with previous exacerbations makes this a high-risk situation. - Requires urgent intervention to prevent respiratory failure. Differential Diagnoses: 1. Acute Exacerbation of COPD (most likely) 2. Pulmonary Embolism (less likely given the history and gradual onset) 3. Pneumonia (less likely without fever or productive cough) 4. Acute Heart Failure (less likely without significant edema or past cardiac history) Required Actions: - Dispatch of ground EMS with ALS capabilities. - Oxygen administration and monitoring. - Bronchodilator therapy if available. - Preparation for transport to nearest hospital with respiratory support.