Hafnarstræti 98, 600 Akureyri, third floor apartment 3B. Five-story concrete building constructed in 1992. Main entrance has a coded lock (code: 2745). One elevator and a central stairwell. Street parking is available, sometimes limited. Building is equipped with a sprinkler system. Current conditions: 8°C, overcast, light wind, good visibility. GPS coordinates: 65.6822° N, 18.0911° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Labored breathing, wheezing, chest tightness, cyanosis around lips. Secondary symptoms: Agitation, confusion, productive cough with yellow sputum. Patient is sitting upright, struggling to breathe. Medical history: COPD diagnosed 5 years ago, hypertension, type 2 diabetes. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (twice daily), Metformin 500mg (twice daily), Lisinopril 10mg (daily). Allergies: Sulfa drugs. Last meal: Light lunch at 13:00. Patient reports increased symptoms over the last 2 hours.
Timeline: 1400 hours: Patient started experiencing increased shortness of breath and wheezing. 1430 hours: Symptoms worsened, developed chest tightness and productive cough. 1445 hours: Patient became agitated and confused, cyanosis around lips noted by spouse. 1450 hours: Caller (spouse) contacted emergency services. 1455 hours: Current time, patient in severe respiratory distress. Prior Events: Patient has had several COPD exacerbations in the past year, one hospitalization 6 months ago. Patient reports a recent upper respiratory infection 3 days ago. Patient has not been compliant with medications as of late. Last medical check-up was 2 months ago.
Initial Impression: Acute Exacerbation of COPD with Hypoxia Justification for F2 Classification: - Severe respiratory distress with signs of hypoxia (cyanosis) - Potential for rapid deterioration and respiratory failure - Time-sensitive condition requiring prompt medical intervention Differential Diagnoses: 1. Acute Exacerbation of COPD (most likely) 2. Pneumonia (possible, given recent infection) 3. Pulmonary Embolism (less likely, no history of DVT) 4. Acute Heart Failure (less likely, no history of CHF) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration and airway management - Bronchodilator therapy - Preparation for transport to nearest hospital with respiratory services