Hafnarstræti 22, 600 Akureyri. Ground floor of a two-story commercial building. Main entrance on Hafnarstræti, secondary entrance at the back with a small parking lot. Building is of older brick construction, built in 1960. No elevators. Building equipped with basic fire alarm system. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6837° N, 18.0917° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe shortness of breath. Primary symptoms: Labored breathing, wheezing, and chest tightness. Secondary symptoms: Increased heart rate, anxiety, and mild cyanosis around the lips. Patient is conscious but appears distressed. Patient is sitting upright in a chair 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), Amlodipine 10mg daily. No known allergies. Last meal was a light lunch at 13:00.
Timeline: 1400 hours: Patient began experiencing mild shortness of breath 1415 hours: Symptoms worsened, difficulty speaking in full sentences 1420 hours: Patient used his salbutamol inhaler, no relief 1425 hours: Symptoms continued to worsen, called emergency services 1428 hours: Current time, patient is still experiencing severe shortness of breath Prior Events: Patient reports a recent cold last week but no fever, has been using his inhalers more frequently. No recent hospitalizations. Last medical check-up 2 months ago, routine follow-up. Patient is a smoker, smokes 1 pack per day.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Moderate to severe respiratory distress with wheezing and cyanosis - Failure of initial bronchodilator treatment - Potential for rapid deterioration and respiratory failure - Time-sensitive condition requiring prompt medical intervention Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pulmonary Embolism (less likely given absence of chest pain) 3. Pneumonia (less likely, no fever reported) 4. Acute Heart Failure (less likely, no history of heart failure) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration and monitoring - Bronchodilator therapy (nebulized) if available - Continuous monitoring of respiratory status - Preparation for transport to nearest hospital with respiratory services