Hafnarstræti 18, 600 Akureyri, Ground floor of a two-story wooden building built in 1955. Main entrance has a small step. No elevator. Street parking available. Building has a basic fire alarm system. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6816° N, 18.0910° W. Nearest landmark: Akureyri Art Museum.
62-year-old male, experiencing severe shortness of breath. Primary symptoms: Difficulty breathing, wheezing, chest tightness. Secondary symptoms: Increased heart rate, anxiety, cyanosis around lips. Patient is conscious but struggling to speak in full sentences. Patient sitting upright in a chair. Medical history: Chronic obstructive pulmonary disease (COPD), diagnosed 5 years ago, hypertension. Medications: Salbutamol inhaler as needed, Fluticasone/Salmeterol inhaler twice daily, Lisinopril 10mg daily. Known allergy: Penicillin. Last meal was a light lunch at 13:00.
Timeline: 1400 hours: Patient reports mild shortness of breath, used his salbutamol inhaler 1415 hours: Shortness of breath worsened, patient attempted to use inhaler again with no relief 1420 hours: Patient experiencing severe respiratory distress, cyanosis noted around lips 1422 hours: Patient's son called emergency services 1425 hours: Current time, patient is struggling to breathe, sitting upright, anxious Prior Events: Patient has had several COPD exacerbations in the past, requiring hospital admission. Last exacerbation was 6 months ago. No recent infections reported. Last medical check-up 2 months ago, routine follow-up. Patient lives with his son.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Patient presents with significant respiratory distress and cyanosis - High risk of rapid deterioration - Requires urgent medical intervention, oxygen therapy and potentially advanced airway management Differential Diagnoses: 1. Acute Exacerbation of COPD (most likely) 2. Pulmonary Embolism (less likely, no sudden onset of chest pain) 3. Pneumonia (possible, but no fever reported) 4. Acute Heart Failure (less likely, no prior history of heart failure) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy initiation - Assessment of respiratory status and lung sounds - Preparation for transport to nearest hospital with respiratory support