Hafnarstræti 18, 600 Akureyri, third floor apartment 3B. A four-story brick building constructed in 1965. The main entrance has a coded lock (1972). One elevator and a central stairwell. Street parking available, sometimes limited. Building has a basic fire alarm system. Current conditions: 8°C, overcast, moderate visibility. GPS coordinates: 65.6823° N, 18.0921° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing acute shortness of breath. Primary symptoms: Severe dyspnea, wheezing, and productive cough with yellowish sputum. Patient is pale and diaphoretic. Secondary symptoms: Chest tightness, anxiety, and mild confusion. Patient is sitting upright, struggling to breathe. Medical history: COPD diagnosed 5 years ago, hypertension, and type 2 diabetes. Medications: Salmeterol/Fluticasone inhaler 50/250 mcg twice daily, Metformin 500mg twice daily, Lisinopril 10mg daily. Known allergy to penicillin. Last meal was a light lunch at 13:00.
Timeline: 1400 hours: Patient started experiencing increased shortness of breath and mild cough 1415 hours: Symptoms worsened, patient began wheezing and coughing up yellow phlegm 1420 hours: Patient felt increasingly anxious and confused, unable to speak in full sentences 1425 hours: Patient's son (caller) found him in distress and called emergency services 1428 hours: Current time, patient is sitting up, struggling to breathe, pale and sweating. Prior Events: Patient had a recent upper respiratory infection 2 weeks ago, treated with over-the-counter medications. No recent hospitalizations. Last medical check-up was 6 months ago, routine follow-up for COPD and diabetes. Patient lives with his son, who is the caller.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Severe respiratory distress with wheezing and productive cough - Patient has underlying COPD, increasing risk of rapid deterioration - Time-sensitive condition requiring prompt medical intervention Differential Diagnoses: 1. Acute Exacerbation of COPD (most likely) 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) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy initiation - Bronchodilator administration - Preparation for transport to nearest hospital with respiratory services