Hafnarstræti 18, 600 Akureyri, third floor apartment 3B. Four-story concrete residential building built in 1965. Main entrance requires a key or intercom. One elevator and a central stairwell. Street parking is available. Building has a fire alarm system. Current conditions: 7°C, overcast, light wind, good visibility. GPS coordinates: 65.6834° N, 18.0921° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Significant difficulty breathing, audible wheezing, rapid respiratory rate, and cyanosis around lips. Secondary symptoms: Chest tightness, anxiety, and mild confusion. Patient is sitting upright, leaning forward, struggling to breathe. Patient has a history of COPD. Medications: Salbutamol inhaler (as needed), Tiotropium inhaler (daily), Prednisone 5mg daily. Allergies: None known. Last meal was a light lunch at 13:00.
Timeline: 1400 hours: Patient started feeling slightly short of breath 1415 hours: Shortness of breath worsened, started wheezing 1420 hours: Patient used his salbutamol inhaler with minimal relief 1425 hours: Patient's breathing became labored, cyanosis noted 1430 hours: Caller (patient's son) arrived and called emergency services 1432 hours: Current time, patient still struggling to breathe, sitting upright Prior Events: Patient has a history of COPD diagnosed 5 years ago, with several exacerbations in the past. Last COPD exacerbation was 3 months ago, treated with oral steroids and antibiotics. No recent illnesses or injuries. Last medical check-up 2 months ago, routine follow-up. Patient lives alone, but son lives nearby.
Initial Impression: Acute Exacerbation of COPD with Respiratory Distress Justification for F2 Classification: - Significant respiratory distress, potential for rapid deterioration - Cyanosis indicates hypoxemia, requiring prompt intervention - Time-sensitive condition requiring oxygen and medication administration Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pulmonary Embolism (less likely given history and presentation) 3. Acute Heart Failure (less likely, no reported history of heart failure) 4. Pneumothorax (less likely, no reported chest pain) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration - Bronchodilator administration - Continuous monitoring of respiratory status - Preparation for transport to nearest hospital