Hafnarstræti 18, 600 Akureyri, first floor, apartment 103. A three-story building constructed in 1965, with a mix of commercial and residential units. Main entrance has a buzzer system. Elevator and stairwell access. Street parking available. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6822° N, 18.0917° W. Nearest landmark: Akureyri Art Museum.
78-year-old male, experiencing severe shortness of breath. Primary symptoms: Rapid, labored breathing, audible wheezing, use of accessory muscles, unable to speak in full sentences. Secondary symptoms: Cyanosis around lips, increased anxiety, productive cough with yellow sputum. Patient is sitting upright on the edge of his bed. Medical history: COPD diagnosed 15 years ago, history of smoking (quit 5 years ago), hypertension, and heart failure. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (twice daily), Ramipril 5mg daily, Furosemide 40mg daily. Allergies: Penicillin. Last meal was a light lunch at 13:00.
Timeline: 1400 hours: Patient started experiencing mild shortness of breath. 1415 hours: Shortness of breath worsened, started wheezing. 1420 hours: Patient used Salbutamol inhaler with minimal relief. 1425 hours: Symptoms continued to worsen, patient became more anxious, developed cyanosis. 1430 hours: Current time, patient is struggling to breathe, unable to speak full sentences. Caller (patient's son) called emergency services. Prior Events: Patient had a COPD exacerbation two months ago requiring a short hospital stay. Recent increase in cough and sputum production over the past week. No fever reported. Last medical check-up 2 weeks ago, routine follow-up. Patient lives alone but son lives in the same building.
Initial Impression: Acute COPD Exacerbation with Respiratory Distress Justification for F2 Classification: - Significant respiratory distress with cyanosis, indicating potential hypoxemia. - Patient's history of COPD and recent exacerbation increases the risk of rapid deterioration. - Time-sensitive condition requiring immediate medical intervention to stabilize breathing. Differential Diagnoses: 1. COPD Exacerbation (high probability) 2. Pneumonia (less likely, no fever reported) 3. Pulmonary Embolism (less likely, no sudden onset of chest pain) 4. Acute Heart Failure (possible, given history, but primary presentation is respiratory) Required Actions: - Dispatch of ground EMS with ALS capabilities. - Oxygen administration and monitoring of oxygen saturation. - Bronchodilator administration and assessment of response. - Preparation for transport to nearest hospital with respiratory services.