Hafnarstræti 22, 600 Akureyri, third floor apartment 3B. A five-story concrete building built in 1965. Main entrance has a key code and intercom. One elevator and a central stairwell. Street parking is available. The building has a fire alarm system. Current conditions: 7°C, overcast, light wind, good visibility. GPS coordinates: 65.6822° N, 18.0924° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath and chest tightness. Primary symptoms: Difficulty breathing, rapid and shallow respirations, audible wheezing. Secondary symptoms: Cyanosis around lips, altered mental status (confused). Patient is sitting upright, leaning forward, appears anxious and distressed. Medical history: COPD diagnosed 5 years ago, history of smoking, hypertension. Medications: Salbutamol inhaler (as needed), Beclomethasone inhaler (twice daily), Lisinopril 10mg daily. No known allergies. Last meal was a light lunch at 13:00.
Timeline: 1400 hours: Patient reports feeling slightly unwell, with mild shortness of breath. 1415 hours: Shortness of breath worsens, patient starts using his Salbutamol inhaler with minimal relief. 1420 hours: Patient's breathing becomes more labored, chest tightness develops, patient becomes confused. 1425 hours: Wife calls emergency services. 1427 hours: Current time, patient is sitting up, struggling to breathe. Prior Events: Patient had a COPD exacerbation 6 months ago requiring hospitalization. No recent infections or changes in medication. Patient has been a smoker for 40 years but recently reduced his smoking. Last medical check-up was 4 months ago, routine follow-up.
Initial Impression: Severe COPD Exacerbation with Respiratory Distress Justification for F2 Classification: - Patient has a history of COPD with acute worsening of respiratory symptoms - Presence of severe dyspnea, wheezing, and cyanosis suggests significant respiratory compromise - Altered mental status indicates potential hypoxemia and requires urgent intervention Differential Diagnoses: 1. COPD Exacerbation (most likely) 2. Acute Pulmonary Embolism (less likely given gradual onset) 3. Pneumonia (possible but less likely without fever) 4. Acute Heart Failure (less likely without peripheral edema) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy administration - Bronchodilator administration - Continuous monitoring of vital signs - Preparation for transport to nearest hospital with respiratory services