Hafnarstræti 18, 600 Akureyri, Ground floor of a two-story wooden building, built in 1935, recently renovated. Main entrance faces the street, no security features. Building has a small parking area in the back. Current conditions: 8°C, overcast, light wind. GPS coordinates: 65.6812° N, 18.0895° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe shortness of breath. Primary symptoms: Rapid and labored breathing, chest tightness, audible wheezing. Secondary symptoms: Increased anxiety, pale skin, productive cough with thick yellow mucus. Patient is conscious but struggling to speak in full sentences. Patient is sitting upright on a chair in his living room. Medical history: Chronic obstructive pulmonary disease (COPD), diagnosed 5 years ago, hypertension. Medications: Salbutamol inhaler (2 puffs as needed), Fluticasone/Salmeterol inhaler (1 puff twice daily), Lisinopril 10mg daily. Known allergy to penicillin. Last meal was a sandwich at 11:00.
Timeline: 1200 hours: Patient started experiencing increased shortness of breath 1210 hours: Patient used his salbutamol inhaler, with minimal relief 1215 hours: Symptoms worsened, started experiencing chest tightness 1220 hours: Patient called his son for help 1225 hours: Son arrived, called emergency services 1228 hours: Current time, patient still struggling to breathe Prior Events: Patient has had several exacerbations of COPD in the past year, requiring hospital visits. Last hospital visit 3 months ago for similar symptoms. No recent infections or fever. Patient is a former smoker, quit 10 years ago.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Significant respiratory distress with wheezing and chest tightness - Patient has known COPD history, indicating high risk - Potential for rapid deterioration requiring urgent intervention Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pneumonia (less likely, no fever reported) 3. Pulmonary Embolism (less likely, no sudden onset of symptoms) 4. Acute Coronary Syndrome (less likely, no reported chest pain) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration and respiratory support - Continuous monitoring of vital signs - Preparation for transport to nearest hospital with respiratory services