Hafnarstræti 22, 600 Akureyri. Ground floor of a two-story wooden building built in 1955. Main entrance is street-level with one step. No elevator. Parking available on the street. No security features. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6819° N, 18.0922° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe shortness of breath. Primary symptoms: Difficulty breathing, wheezing, chest tightness. Secondary symptoms: Anxiety, rapid heart rate, cyanosis around lips. Patient is conscious but agitated. Patient sitting upright on a chair in his living room. Medical history: COPD diagnosed 5 years ago, history of smoking, hypertension. Medications: Salbutamol inhaler (as needed), Fluticasone inhaler (2 puffs twice daily), Ramipril 5mg daily. Allergies: None known. Last meal was a light lunch at 13:00.
Timeline: 1410 hours: Patient reports feeling increasingly short of breath. 1415 hours: Patient used his salbutamol inhaler with minimal relief. 1420 hours: Symptoms worsened, including chest tightness and wheezing. 1425 hours: Patient called his son for help. 1430 hours: Son arrived, called emergency services. 1432 hours: Current time, patient is still struggling to breathe. Prior Events: Patient had a COPD exacerbation 3 months ago, treated with oral steroids and antibiotics. Has been using inhalers regularly. Smoked for 40 years, quit 2 years ago. Last medical check-up 6 months ago, routine follow-up. Patient lives alone, son lives nearby.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Patient presenting with significant respiratory distress, likely due to COPD exacerbation. - Cyanosis indicates hypoxemia, requiring urgent medical attention. - Time-sensitive condition requiring prompt oxygen therapy and bronchodilator treatment. Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pulmonary Embolism (less likely given gradual onset and history of COPD) 3. Acute Bronchitis (less likely given chronic history of COPD) 4. Pneumonia (possible, but less likely given no reported fever or productive cough) 5. Cardiac related dyspnea (less likely given history of COPD) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy initiation - Bronchodilator administration (nebulized if possible) - Preparation for transport to nearest hospital with respiratory services