Hafnarstræti 94, 600 Akureyri, ground floor of a two-story commercial building, converted to residential. Constructed in 1958, concrete with wooden accents. Main entrance is street level, no steps. No elevator, one internal stairwell. Street parking available. Building has a standard lock and no security system. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6816° N, 18.0897° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe shortness of breath and chest tightness. Primary symptoms: Rapid, shallow breathing, wheezing, productive cough with yellow sputum. Secondary symptoms: Cyanosis around lips, increased anxiety, diaphoresis. Patient is conscious but struggling to speak. Patient is sitting upright on a chair in his living room. Medical history: Chronic obstructive pulmonary disease (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. Known allergy to penicillin. Last meal was a light lunch at 13:00.
Timeline: 1400 hours: Patient started feeling slightly short of breath, attributed it to usual COPD 1415 hours: Shortness of breath worsened, patient used salbutamol inhaler, with minimal relief 1430 hours: Symptoms progressed to severe breathing difficulty, chest tightness, and cough with yellow sputum 1435 hours: Patient called his son for help 1440 hours: Son arrived and called emergency services 1442 hours: Current time, patient is struggling to breathe, sitting upright on a chair Prior Events: Patient had a mild upper respiratory infection 2 weeks ago, fully recovered. Patient reports occasional exacerbations of COPD, usually managed with increased inhaler use. Last medical check-up 6 months ago, routine follow-up. Patient lives alone but son lives nearby.
Initial Impression: Acute Exacerbation of COPD with possible lower respiratory tract infection Justification for F2 Classification: - Significant respiratory distress with cyanosis and productive cough - Patient has known COPD, increasing the risk of rapid deterioration - Time-sensitive condition requiring prompt medical intervention and oxygen therapy Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pneumonia (possible given productive cough and history of recent infection) 3. Pulmonary Embolism (less likely given lack of sudden onset and chest pain description) 4. Acute Heart Failure (less likely given primary respiratory symptoms) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy initiation - Bronchodilator administration - Preparation for transport to nearest hospital with respiratory services