Hafnarstræti 96, 600 Akureyri, ground floor of the commercial building, Suite 101. A two-story concrete building constructed in 1965, with a main entrance on Hafnarstræti and a secondary entrance from the parking area in the back. The building is equipped with a fire alarm system. Current conditions: 7°C, overcast, light wind. GPS coordinates: 65.6831° N, 18.0927° W. Nearest landmark: Akureyri Art Museum.
62-year-old male, experiencing severe shortness of breath. Primary symptoms: Severe dyspnea, rapid breathing, wheezing, cyanosis around the lips. Patient is conscious but agitated, struggling to speak in full sentences. Secondary symptoms: Chest tightness, productive cough with yellowish sputum. Patient is sitting upright in his office chair. Medical history: Chronic obstructive pulmonary disease (COPD) diagnosed 5 years ago, history of smoking. Medications: Salbutamol inhaler (2 puffs as needed), Tiotropium inhaler (1 puff daily), Prednisone 5mg daily. Known allergy: Penicillin. Last meal was a light lunch at 13:00.
Timeline: 14:30 hours: Patient reports feeling increasingly short of breath, used his salbutamol inhaler with minimal relief 14:40 hours: Symptoms worsened, began experiencing chest tightness and productive cough 14:45 hours: Patient called his colleague for assistance 14:48 hours: Colleague called emergency services 14:50 hours: Current time, patient is struggling to breathe, appears cyanotic Prior Events: Patient reports a COPD exacerbation 2 months ago requiring hospitalization. Has been compliant with medications. No recent illnesses or injuries. Last medical check-up 1 month ago, routine follow-up. Patient works in the office alone most of the day.
Initial Impression: Acute Exacerbation of COPD with Respiratory Distress Justification for F2 Classification: - Severe dyspnea, cyanosis, and inability to speak in full sentences indicate significant respiratory compromise. - History of COPD and recent exacerbation increases risk of rapid deterioration. - Time-sensitive condition requiring prompt medical intervention, including oxygen therapy and potential bronchodilators. Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pulmonary Embolism (less likely, no sudden onset of sharp chest pain) 3. Pneumonia (possible, but less likely given history and symptoms) 4. Acute Heart Failure (less likely, no history of heart disease) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy initiation - Bronchodilator administration - Preparation for transport to nearest hospital with respiratory services