Hafnarstræti 18, 600 Akureyri, ground floor of a two-story wooden building built in 1935. Main entrance is on the street level, no elevator. Street parking available. Building has basic fire safety equipment. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6821° N, 18.0901° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Difficulty breathing, wheezing, chest tightness, productive cough with yellow sputum. Secondary symptoms: Increased heart rate, pale skin, mild confusion. Patient is sitting upright, leaning forward. Medical history: COPD diagnosed 5 years ago, hypertension, previous smoker. Medications: Salbutamol inhaler (2 puffs PRN), Fluticasone/Salmeterol inhaler (1 puff twice daily), Lisinopril 10mg daily. Known allergy to penicillin. Last meal was a light lunch at 13:00.
Timeline: 1400 hours: Patient began experiencing mild shortness of breath. 1430 hours: Symptoms worsened, developed chest tightness and wheezing. 1445 hours: Patient used Salbutamol inhaler, with minimal relief. 1450 hours: Patient's son called emergency services. 1455 hours: Current time, patient still experiencing severe respiratory distress. Prior Events: Patient had a similar episode 3 months ago, treated with oral steroids. No recent infections reported. Patient reports increased cough and sputum production for the past 3 days. 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: - Moderate respiratory distress with increased work of breathing and wheezing. - Potential for rapid deterioration, requiring timely intervention. - Patient has known COPD, increasing risk of respiratory failure. Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pneumonia (possible, given productive cough) 3. Pulmonary Embolism (less likely, no risk factors reported) 4. Acute Heart Failure (less likely, no history of heart disease) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration protocol initiation - Bronchodilator administration as per protocol - Preparation for transport to nearest hospital with respiratory services