Hafnarstræti 18, 600 Akureyri. Second floor of a three-story commercial building. Main entrance on Hafnarstræti, accessible via a short flight of stairs. No elevator. Building constructed in 1965, concrete structure. Street parking available. The building has a fire alarm system. Current conditions: 7°C, overcast, moderate visibility. GPS coordinates: 65.6812° N, 18.0902° W. Nearest landmark: Hof Cultural and Conference Center.
65-year-old male, experiencing severe shortness of breath. Primary symptoms: Acute onset of dyspnea, wheezing, and chest tightness. Secondary symptoms: Pale skin, mild cyanosis around lips, increased respiratory rate, use of accessory muscles for breathing. Patient is conscious but anxious. Patient is sitting upright in his office. Medical history: Chronic obstructive pulmonary disease (COPD) diagnosed 5 years ago, hypertension. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (twice daily), Lisinopril 10mg daily. Allergies: None known. Last meal was a light lunch at 12:00.
Timeline: 13:30 hours: Patient reports feeling mild shortness of breath while working 13:40 hours: Symptoms worsened, patient started using his Salbutamol inhaler, with minimal relief 13:45 hours: Patient's condition deteriorated rapidly with increased wheezing and chest tightness 13:48 hours: Patient called his colleague, who called emergency services 13:50 hours: Current time, patient is struggling to breathe, still sitting upright Prior Events: Patient reports a recent upper respiratory infection a week ago. No recent hospitalizations. Last COPD check-up 6 months ago, stable condition reported. Patient is a smoker, history of 30 pack-years.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Significant respiratory distress with potential for rapid deterioration - Patient's history of COPD and recent respiratory infection increase risk - Time-sensitive condition requiring prompt intervention and oxygen therapy Differential Diagnoses: 1. Acute Exacerbation of COPD (most likely) 2. Pneumonia (possible, given recent infection) 3. Pulmonary Embolism (less likely, no reported leg pain or swelling) 4. Acute Coronary Syndrome (less likely, chest pain is not primary symptom) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy initiation - Bronchodilator administration - Preparation for transport to nearest hospital with respiratory support