Hafnarstræti 18, 600 Akureyri, ground floor of a two-story wooden building built in 1930. Main entrance is street-level with one step. No elevator. Limited parking available. Building has basic security, no codes. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6834° N, 18.0876° W. Nearest landmark: Akureyri Art Museum.
35-year-old male, experiencing severe shortness of breath. Primary symptoms: Wheezing, difficulty breathing, chest tightness, rapid breathing. Secondary symptoms: Mild cyanosis around lips, increased heart rate, anxious. Patient is conscious but struggling to speak. Patient is sitting upright on a chair in his office. Medical history: Asthma diagnosed in childhood, seasonal allergies. Medications: Salbutamol inhaler (Ventolin) as needed, Fluticasone inhaler (Flovent) 250mcg twice daily. Known allergy to dust mites. Last meal was lunch at 13:00 (sandwich and apple).
Timeline: 1415 hours: Patient began feeling mild shortness of breath, thought it was due to dust 1430 hours: Symptoms worsened, wheezing started, used salbutamol inhaler with no relief 1440 hours: Symptoms rapidly increased, chest tightness and difficulty speaking developed 1445 hours: Patient called emergency services 1447 hours: Current time, patient is struggling to breathe, appears distressed Prior Events: Patient reports several asthma attacks in the past, usually controlled with inhaler. Last asthma exacerbation was 6 months ago. No recent illnesses or injuries. Last medical check-up 2 months ago, routine follow-up. Patient works in an office environment.
Initial Impression: Acute Asthma Exacerbation Justification for F2 Classification: - Significant respiratory distress with wheezing and cyanosis - Failure of initial bronchodilator therapy - Potential for rapid deterioration into respiratory failure - Time-sensitive condition requiring prompt medical intervention Differential Diagnoses: 1. Acute Asthma Exacerbation (high probability) 2. Anaphylaxis (less likely, no known exposure to allergens) 3. Pulmonary Embolism (less likely, no risk factors) 4. Pneumonia (less likely, no fever or productive cough) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration and continuous monitoring - Administration of nebulized bronchodilators - Preparation for possible intubation and mechanical ventilation