Hafnarstræti 18, 600 Akureyri. Ground floor of a two-story commercial building, built in 1960. Main entrance at street level with a single glass door. No elevator. Parking available on the street. Building has a basic fire alarm system. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6821° N, 18.0925° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe shortness of breath. Primary symptoms: Rapid, shallow breathing, wheezing, and use of accessory muscles. Secondary symptoms: Cyanosis around lips, increased heart rate, and reported chest tightness. Patient is conscious but anxious. Medical history: Chronic Obstructive Pulmonary Disease (COPD) diagnosed 5 years ago, hypertension. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (twice daily), Amlodipine 10mg daily. Allergies: None known. Last meal: Light lunch at 13:00. Patient is sitting in a chair in his office.
Timeline: 1410 hours: Patient began feeling mild shortness of breath 1415 hours: Shortness of breath worsened rapidly, associated with wheezing 1420 hours: Patient used his salbutamol inhaler, with minimal relief 1425 hours: Patient became increasingly distressed, started to feel chest tightness 1430 hours: Patient called his son, who called emergency services 1432 hours: Current time, patient is struggling to breathe, cyanotic around lips Prior Events: Patient reports increased shortness of breath over the past few days, but denies any recent infections. Last COPD exacerbation was 6 months ago, treated with oral corticosteroids. Last medical check-up 2 months ago, routine follow-up. Patient is a smoker (1 pack per day for 40 years).
Initial Impression: Acute Exacerbation of COPD with Respiratory Distress Justification for F2 Classification: - Significant respiratory distress with signs of hypoxia (cyanosis) - Time-sensitive condition requiring immediate intervention - Patient has a history of COPD, increasing the risk of rapid deterioration Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pneumonia (possible, but less likely given no reported fever) 3. Pulmonary Embolism (less likely given lack of sudden onset) 4. Acute Heart Failure (possible, but less likely given primary respiratory symptoms) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy and bronchodilator administration - Continuous monitoring of vital signs and respiratory status - Preparation for transport to nearest hospital with respiratory services