Hafnarstræti 22, 600 Akureyri, ground floor of a two-story wooden building, built in 1950, main entrance facing the street. No elevator, stairwell access to the second floor. Street parking available, usually congested. Building equipped with basic fire safety measures. Current conditions: 7°C, cloudy, good visibility. GPS coordinates: 65.6810° N, 18.0900° W. Nearest landmark: Akureyri Art Museum.
62-year-old male, experiencing severe shortness of breath and chest tightness. Primary symptoms: Difficulty breathing, wheezing, rapid breathing. Secondary symptoms: Pale skin, anxiety, productive cough with clear sputum. Patient is conscious but agitated. Patient is sitting upright on a chair in his living room. Medical history: Chronic obstructive pulmonary disease (COPD), hypertension. Medications: Salbutamol inhaler (2 puffs as needed), Beclometasone inhaler (2 puffs twice daily), Lisinopril 10mg daily. Known allergy: Sulfa drugs. Last meal was a light lunch at 13:00.
Timeline: 1400 hours: Patient began feeling slightly short of breath 1415 hours: Symptoms worsened, with increased wheezing and chest tightness 1420 hours: Patient used his salbutamol inhaler with minimal relief 1425 hours: Patient coughed up some clear sputum 1430 hours: Current time, patient is struggling to breathe, called emergency services Prior Events: Patient has a history of COPD exacerbations, with the last one occurring 3 months ago, requiring hospitalization. Patient reports increased cough and mucus production over the past 2 days. Last medical check-up was 2 months ago, routine follow-up for COPD management. Patient lives alone.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Patient experiencing severe respiratory distress with a known history of COPD - Symptoms include significant shortness of breath, wheezing, and rapid breathing - Potential for rapid deterioration requiring urgent medical intervention Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pneumonia (possible, given productive cough) 3. Pulmonary Embolism (less likely, no chest pain described) 4. Acute Heart Failure (less likely, no known history of heart failure) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration upon arrival - Bronchodilator administration via nebulizer - Monitoring of respiratory status and vital signs - Preparation for transport to nearest hospital with respiratory services