Hafnarstræti 18, 600 Akureyri, third floor apartment 3B. A five-story reinforced concrete building constructed in 1995. Main entrance requires a key or intercom. There is one elevator and a central stairwell. Street parking available. The building is equipped with a fire alarm system. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6823° N, 18.0921° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Rapid, shallow breathing, wheezing, and chest tightness. Patient is conscious but agitated. Secondary symptoms: Mild cyanosis around the lips, increased heart rate. Patient is sitting upright in a chair. Medical history: Chronic Obstructive Pulmonary Disease (COPD) diagnosed 5 years ago, hypertension, and a history of smoking. Medications: Salbutamol inhaler (as needed), Tiotropium inhaler (daily), Amlodipine 5mg daily. No known allergies. Last meal was a light lunch at 12:30.
Timeline: 1345 hours: Patient began experiencing mild shortness of breath. 1400 hours: Shortness of breath worsened rapidly, accompanied by wheezing. 1405 hours: Patient attempted to use his salbutamol inhaler with minimal relief. 1410 hours: Patient's son called emergency services. 1415 hours: Current time, patient is sitting upright, struggling to breathe. Prior Events: Patient reports a recent upper respiratory infection last week, which he thought was resolving. He has had similar but less severe episodes in the past, typically managed with his inhalers. No recent hospitalizations. Last medical check-up was 6 months ago, routine follow-up.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Respiratory distress with signs of increased work of breathing and potential hypoxia - Time-sensitive condition requiring prompt medical intervention - History of COPD makes acute exacerbation highly probable Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pneumonia (possible, given recent infection) 3. Pulmonary Embolism (less likely given no sudden onset of chest pain) 4. Acute Heart Failure (less likely given absence of significant edema or other cardiac symptoms) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration and assessment of oxygen saturation - Bronchodilator therapy with nebulized medication - Preparation for transport to nearest hospital with respiratory services