Hafnarstræti 21, 600 Akureyri, third floor apartment 3B. Five-story reinforced concrete building constructed in 1995. Main entrance has a coded lock (code 1972). Elevator and stairwell access. Street parking available. Building equipped with a sprinkler system. Current conditions: 7°C, overcast, moderate wind. GPS coordinates: 65.6822° N, 18.0928° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe shortness of breath. Primary symptoms: Rapid, labored breathing, audible wheezing, use of accessory muscles, pale skin, anxiety. Secondary symptoms: Chest tightness, mild cough, unable to speak in full sentences. Patient is sitting upright on the edge of his bed. Medical history: COPD diagnosed 5 years ago, hypertension, previous myocardial infarction 2 years ago. Medications: Salbutamol inhaler (2 puffs as needed), Tiotropium inhaler (1 puff daily), Ramipril 5mg daily, Aspirin 75mg daily. Known allergy: Penicillin. Last meal was a small sandwich at 11:00.
Timeline: 1200 hours: Patient reports onset of mild shortness of breath 1215 hours: Symptoms progressively worsened, now experiencing severe difficulty breathing 1220 hours: Patient attempted to use his salbutamol inhaler, no significant improvement 1225 hours: Patient called his son for help 1230 hours: Son arrived, called emergency services 1232 hours: Current time, patient struggling to breathe, unable to speak clearly Prior Events: Patient has had several COPD exacerbations in the past, with one hospitalization in the past year. Reports a cold for the past few days, but no fever. No recent changes in medications. Patient lives alone, but son lives nearby.
Initial Impression: Acute COPD Exacerbation with Respiratory Distress Justification for F2 Classification: - Significant respiratory distress with use of accessory muscles and wheezing - History of COPD and recent cold suggests exacerbation - Patient's inability to speak in full sentences indicates severity - Time-sensitive condition requiring prompt intervention and oxygen therapy Differential Diagnoses: 1. Acute COPD Exacerbation (high probability) 2. Acute Heart Failure (less likely, but must be considered due to prior MI) 3. Pneumonia (possible, but less likely given acute onset) 4. Pulmonary Embolism (lower probability, no history of DVT or recent surgery) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy initiation - Bronchodilator administration - Continuous monitoring of vital signs - Preparation for transport to nearest hospital with respiratory support