Hafnarstræti 18, 600 Akureyri, third floor apartment 3B. A five-story concrete apartment building built in 1995. Main entrance is accessible by key or intercom. One elevator and a central staircase. Street parking available, sometimes limited. Building has a basic fire alarm system. Current conditions: 7°C, overcast, light wind. GPS coordinates: 65.6832° N, 18.0911° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Rapid, labored breathing, chest tightness, audible wheezing. Secondary symptoms: Mild cyanosis around lips, productive cough with clear sputum, feeling of panic. Patient is conscious but appears anxious and distressed. Medical history: COPD diagnosed 5 years ago, hypertension, previous smoker. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (twice daily), Lisinopril 10mg daily. Known allergy: Penicillin. 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, accompanied by wheezing. 1420 hours: Patient used his Salbutamol inhaler with minimal relief. 1425 hours: Patient began experiencing chest tightness and increased anxiety. 1430 hours: Patient called his son for help, who then called emergency services. 1435 hours: Current time, patient is sitting upright, struggling to breathe. Prior Events: Patient reports a recent cold 3 weeks ago, which has been slowly resolving. He has had several exacerbations of COPD in the past, requiring hospital admission. He has been compliant with his medications. No recent travel or significant changes in health.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Significant respiratory distress with rapid onset - Potential for rapid deterioration - Requires prompt medical intervention including oxygen and bronchodilators Differential Diagnoses: 1. Acute Exacerbation of COPD (most likely) 2. Pneumonia (less likely given no fever reported) 3. Pulmonary Embolism (less likely given no sudden onset of symptoms) 4. Acute Heart Failure (less likely given chronic COPD history) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration upon arrival - Assessment of respiratory status and vital signs - Preparation for potential assisted ventilation - Rapid transport to hospital for further evaluation and treatment