Hafnarstræti 18, 600 Akureyri, first floor of a two-story commercial building. The building is a mixed-use structure with retail on the ground floor and offices above. The main entrance is on Hafnarstræti, with a secondary entrance at the back. There is street parking available. The building is of standard concrete construction, built in 1985. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6821° N, 18.0912° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Rapid and labored breathing, audible wheezing, use of accessory muscles. Secondary symptoms: Increased anxiety, pale skin, reported chest tightness. Patient is conscious but distressed. Medical history: Chronic obstructive pulmonary disease (COPD), history of smoking, previous pneumonia. Medications: Salbutamol inhaler (as needed), Tiotropium inhaler (daily), Prednisolone 5mg daily. No known allergies. Last meal was a light lunch at 12:30.
Timeline: 1315 hours: Patient reports mild shortness of breath while walking 1320 hours: Symptoms worsen rapidly, becoming severe with wheezing 1325 hours: Patient takes two puffs of Salbutamol inhaler with minimal relief 1330 hours: Patient calls emergency services, unable to speak in full sentences 1332 hours: Current time, patient is sitting, leaning forward, struggling to breathe Prior Events: Patient has had several COPD exacerbations in the past, most recently 6 months ago. Patient has been compliant with medications. No recent illnesses or injuries. Last medical check-up 2 months ago, routine follow-up. Patient lives with his wife, who is present but distressed.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Severe respiratory distress with use of accessory muscles - Patient's history of COPD and rapid symptom onset - Potential for rapid deterioration requiring prompt intervention - Time-sensitive condition, requiring oxygen therapy and possible medication administration Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pneumonia (less likely, no fever reported) 3. Pulmonary Embolism (less likely, no sudden chest pain reported) 4. Acute Heart Failure (less likely, no history of heart disease) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy initiation - Assessment of respiratory status - Medication administration (nebulized bronchodilators) - Preparation for transport to nearest hospital