Hafnarstræti 18, 600 Akureyri. Third floor apartment 3B. Five-story concrete building constructed in 1985. Main entrance has a coded lock (code: 1985). Elevator and central stairwell available. Street parking with limited availability. Building has a basic fire alarm system. Current conditions: 7°C, overcast, moderate visibility. GPS coordinates: 65.6834° N, 18.0895° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe shortness of breath. Primary symptoms: Acute onset of dyspnea, wheezing, chest tightness. Secondary symptoms: Mild cyanosis around lips, productive cough with yellowish sputum. Patient is conscious but anxious, sitting upright and struggling to breathe. History: COPD diagnosed 5 years ago, previous exacerbations. Medications: Salbutamol inhaler (2 puffs as needed), Fluticasone/Salmeterol inhaler (1 puff twice daily), Prednisone 5mg daily. Allergies: None known. Last meal was a light lunch at 13:00. The incident started approximately 1 hour ago and has progressively worsened.
Timeline: 1400 hours: Patient started feeling mild shortness of breath 1415 hours: Symptoms worsened, developed wheezing and chest tightness 1430 hours: Patient used his Salbutamol inhaler, no relief 1445 hours: Patient's condition continues to deteriorate, cough with sputum started 1450 hours: Caller (patient's son) called emergency services 1455 hours: Current time, patient is very distressed, struggling to breathe Prior Events: Patient has had several COPD exacerbations in the past year, requiring hospital admission. Last exacerbation was 2 months ago. Patient reports a recent mild cold 3 days ago. No other significant medical history. Patient lives with his son.
Initial Impression: Acute COPD Exacerbation with Respiratory Distress Justification for F2 Classification: - Acute onset of significant respiratory distress with wheezing and cyanosis - History of COPD with previous exacerbations - Unresponsive to initial bronchodilator treatment - Potential for rapid deterioration requiring urgent intervention Differential Diagnoses: 1. Acute COPD Exacerbation (most likely) 2. Pneumonia (possible, given productive cough) 3. Pulmonary Embolism (less likely, no risk factors reported) 4. Acute Heart Failure (less likely, no history of heart disease) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy administration - Bronchodilator administration - Consider IV access for medications - Preparation for transport to nearest hospital with respiratory services