Hafnarstræti 98, 600 Akureyri, first floor of a two-story wooden building constructed in 1950. Main entrance is accessible via two steps. No elevator. Street parking available. Building has a basic fire alarm system. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6824° N, 18.0898° W. Nearest landmark: Akureyri Art Museum.
62-year-old male, experiencing severe shortness of breath. Primary symptoms: Rapid, shallow breathing, use of accessory muscles, unable to speak in full sentences, cyanosis around lips. Secondary symptoms: Chest tightness, anxiety, productive cough with yellowish sputum. Patient is conscious but appears distressed. Medical history: COPD diagnosed 5 years ago, type 2 diabetes. Medications: Salbutamol inhaler (2 puffs as needed), Fluticasone/Salmeterol inhaler (1 puff twice daily), Metformin 500mg twice daily. Allergies: Sulfa drugs. Last meal was a light lunch at 13:00.
Timeline: 1400 hours: Patient started experiencing mild shortness of breath 1415 hours: Symptoms worsened, patient used his salbutamol inhaler (2 puffs), no relief 1430 hours: Shortness of breath became severe, unable to complete sentences 1440 hours: Patient called his son for help 1445 hours: Son arrived and called emergency services 1447 hours: Current time, patient still experiencing severe respiratory distress Prior Events: Patient reports a recent cold 3 days ago, no fever. No recent changes in medication. Has had multiple COPD exacerbations in the past year. Last medical check-up was 2 months ago, routine follow-up. Patient lives alone, son lives nearby.
Initial Impression: Acute Exacerbation of COPD with Respiratory Distress Justification for F2 Classification: - Severe respiratory distress with cyanosis, use of accessory muscles, and inability to speak in full sentences - High risk of respiratory failure requiring urgent medical intervention - Time-sensitive condition requiring rapid assessment and treatment Differential Diagnoses: 1. Acute Exacerbation of COPD (most likely) 2. Pneumonia (possible, given recent cold) 3. Pulmonary Embolism (less likely, no sudden onset of sharp chest pain) 4. Acute Heart Failure (less likely, no history of heart failure) Required Actions: - Dispatch of ground EMS with ALS capabilities - High-flow oxygen administration - Bronchodilator therapy (nebulized salbutamol/ipratropium) - Preparation for possible intubation and mechanical ventilation - Rapid transport to nearest hospital with respiratory services