Hafnarstræti 96, 600 Akureyri, first floor apartment 1B. Three-story concrete building constructed in 1968. Main entrance is on the street level, no elevator. Stairwell access only. Street parking available. Building equipped with basic smoke detectors. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6827° N, 18.0901° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Rapid and labored breathing, chest tightness, wheezing. Patient is sitting upright, struggling to speak in full sentences. Secondary symptoms: Mild cyanosis around lips, increased heart rate. Patient is alert but anxious. Medical history: Chronic Obstructive Pulmonary Disease (COPD) diagnosed 5 years ago, hypertension, previous myocardial infarction. Medications: Salbutamol inhaler PRN, Tiotropium inhaler daily, Ramipril 5mg daily, Aspirin 75mg daily. Known allergy to penicillin. Last meal was a light lunch at 13:00. Patient is at home, in his living room.
Timeline: 1400 hours: Patient started feeling slightly short of breath 1415 hours: Shortness of breath worsened, patient used salbutamol inhaler with minimal relief 1420 hours: Patient reports increased chest tightness and wheezing 1425 hours: Patient called his son for help, son arrived 1428 hours: Son called emergency services 1430 hours: Current time, patient still struggling to breathe, sitting upright Prior Events: Patient reports a COPD exacerbation 2 months ago, treated with oral steroids and antibiotics. Patient has been compliant with his daily medications. No recent infections reported. No changes in medications recently. No recent travel.
Initial Impression: Acute COPD Exacerbation with Respiratory Distress Justification for F2 Classification: - Significant respiratory distress with labored breathing, wheezing, and cyanosis - History of COPD with previous exacerbations - Time-sensitive condition requiring prompt medical intervention to prevent respiratory failure Differential Diagnoses: 1. Acute COPD Exacerbation (most likely) 2. Acute Pulmonary Edema (less likely given history and lack of specific symptoms) 3. Pneumonia (possible, but no fever reported) 4. Pulmonary Embolism (less likely given gradual onset of symptoms) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration and respiratory support - Initiation of bronchodilator therapy - Preparation for transport to nearest hospital with respiratory services