Hafnarstræti 96, 600 Akureyri, first floor of a two-story wooden building built in 1950. Main entrance on the street level, no elevator. Street parking available. Building has a basic fire alarm system. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6822° N, 18.0901° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Rapid, labored breathing, wheezing, unable to speak in full sentences, cyanosis around lips. Secondary symptoms: Chest tightness, anxiety, productive cough with thick yellow sputum. Patient is sitting upright, leaning forward. Medical history: COPD diagnosed 5 years ago, hypertension, type 2 diabetes. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (twice daily), Metformin 500mg (twice daily), Lisinopril 10mg (daily). Allergies: Penicillin. Last meal was lunch at 13:00, a sandwich and soup. No recent changes in medication. Reports feeling unwell since yesterday evening, worsening this morning.
Timeline: Yesterday 18:00: Patient started feeling slightly unwell, mild cough. Today 06:00: Increased shortness of breath, started using Salbutamol inhaler more frequently. Today 09:00: Symptoms worsened significantly, difficult to breathe, started producing thick sputum. Today 14:10: Current time, patient in severe respiratory distress, unable to speak full sentences, cyanotic around the lips. Called emergency services. Prior Events: Patient has had several COPD exacerbations in the past year, requiring hospital admission. Last check-up with pulmonologist 2 months ago, routine follow-up. No recent travel or exposure to known respiratory irritants. Patient lives alone.
Initial Impression: Acute Exacerbation of COPD with possible Respiratory Failure Justification for F2 Classification: - Significant respiratory distress, cyanosis, inability to speak in full sentences indicates potential life threat - Patient has underlying COPD, known risk for rapid deterioration - Time-sensitive condition requiring prompt medical intervention, including possible oxygen therapy and bronchodilators Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pneumonia (possible, given productive cough) 3. Pulmonary Embolism (less likely, no sudden onset of chest pain) 4. Acute Heart Failure (less likely, no history of heart failure, primary symptom is respiratory) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy initiation upon arrival - Bronchodilator administration (nebulized if possible) - Preparation for transport to hospital with respiratory support services