Hafnarstræti 18, 600 Akureyri, ground floor of a commercial building, Suite 102. A two-story concrete building, built in 1965, with street-level access. Main entrance is a glass door with a small step. No elevators. Street parking available. Building has a basic fire alarm system. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6818° N, 18.0915° W. Nearest landmark: Hof Cultural and Conference Center.
62-year-old male, experiencing acute shortness of breath. Primary symptoms: Severe dyspnea, audible wheezing, chest tightness. Secondary symptoms: Mild cyanosis around lips, productive cough with thick yellow sputum. Patient is conscious but anxious. Patient is sitting upright, leaning forward in his office. Medical history: COPD diagnosed 5 years ago, history of smoking (2 packs/day for 40 years), seasonal allergies. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (2 puffs twice daily), Prednisone 10mg (daily). Allergies: Pollen. Last meal was a sandwich at 12:00. Recent upper respiratory infection 3 days ago.
Timeline: 1400 hours: Patient started feeling mild shortness of breath, attributed to allergies 1415 hours: Symptoms worsened, began using salbutamol inhaler, with minimal relief 1430 hours: Breathing became increasingly difficult, chest tightness intensified 1440 hours: Patient started coughing up thick yellow sputum 1445 hours: Patient called emergency services, unable to speak in full sentences 1447 hours: Current time, patient is leaning forward, struggling to breathe Prior Events: Patient had a similar episode 6 months ago, treated with oral steroids and antibiotics. Recent upper respiratory infection treated with over-the-counter medications. No recent hospitalizations for COPD exacerbation. Patient has not been compliant with smoking cessation advice.
Initial Impression: Acute COPD Exacerbation with possible lower respiratory infection Justification for F2 Classification: - Significant respiratory distress with wheezing and cyanosis - History of COPD with recent respiratory infection - Time-sensitive condition requiring prompt intervention to prevent respiratory failure Differential Diagnoses: 1. COPD Exacerbation (high probability) 2. Pneumonia (possible, given productive cough) 3. Acute Bronchitis (less likely given history of COPD) 4. Pulmonary Embolism (lower probability, no reported chest pain) 5. Acute Allergic Reaction (less likely given symptoms and history) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy initiation - Bronchodilator administration - Preparation for transport to nearest hospital with respiratory support