Hafnarstræti 18, 600 Akureyri. Second floor of a three-story mixed-use building. Main entrance at street level with a shared staircase. No elevator. Building is approximately 60 years old, constructed of concrete and wood. No specific security features. Weather: 8°C, overcast, light wind. GPS coordinates: 65.6821° N, 18.0914° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe shortness of breath. Primary symptoms: Difficulty breathing, wheezing, rapid and shallow respirations. Secondary symptoms: Chest tightness, productive cough with yellowish sputum, cyanosis around lips. Patient is conscious but agitated. Medical history: Chronic obstructive pulmonary disease (COPD), hypertension, type 2 diabetes. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (twice daily), Metformin 500mg twice daily, Lisinopril 10mg daily. Allergies: None known. Last meal: Light lunch at 13:00.
Timeline: 1400 hours: Patient began experiencing increased shortness of breath. 1415 hours: Symptoms worsened, started wheezing and coughing. 1420 hours: Patient used salbutamol inhaler, no relief. 1425 hours: Patient’s condition continued to deteriorate, became increasingly distressed. 1430 hours: Caller (patient's son) contacted emergency services. Prior Events: Patient has a history of COPD exacerbations, with last hospitalization 6 months ago. No recent changes in medication. Patient reports feeling unwell for the past two days with increased cough and sputum production. No fever reported.
Initial Impression: Acute Exacerbation of COPD with Possible Respiratory Failure. Justification for F2 Classification: - Severe respiratory distress with rapid onset and failure to respond to initial treatment - Patient has known COPD with a history of exacerbations - Presence of cyanosis and altered mental status suggests a potential life-threatening condition Differential Diagnoses: 1. Acute Exacerbation of COPD (most likely) 2. Pneumonia (possible, given productive cough) 3. Pulmonary Embolism (less likely, no sudden onset of pleuritic chest pain) 4. Acute Heart Failure (less likely, no history of heart failure) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration and respiratory support - Preparation for possible intubation - Transport to nearest hospital with respiratory support facilities