Hafnarstræti 23, 600 Akureyri, ground floor of a two-story wooden building constructed in 1950. Main entrance is at street level, no steps. Secondary entrance at rear with a small ramp. No elevator. Street parking is available. Building has a basic fire alarm system. Current conditions: 7°C, overcast, light wind. GPS coordinates: 65.6822° N, 18.0915° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, sudden onset of severe shortness of breath. Primary symptoms: Rapid, labored breathing, audible wheezing, chest tightness. Secondary symptoms: Pale, diaphoretic, anxious. Patient is conscious but struggling to speak in full sentences. Medical history: Known COPD, previous hospitalizations for exacerbations. Medications: Salbutamol inhaler (2 puffs PRN), Fluticasone/Salmeterol inhaler (1 puff BID), Theophylline 200mg daily. Allergies: Penicillin. Last meal was a sandwich at 12:00. Patient was sitting in his living room when symptoms began.
Timeline: 1310 hours: Patient reports feeling slightly unwell, minor cough 1315 hours: Sudden onset of severe shortness of breath, chest tightness 1316 hours: Patient used Salbutamol inhaler, no relief 1317 hours: Patient's son called emergency services 1320 hours: Current time, patient struggling to breathe, very anxious Prior Events: Patient had a mild cold last week. Reports increased sputum production for 2 days. No recent changes in medications. Last medical check-up 2 months ago, routine follow-up. Patient lives with his son, who is currently present.
Initial Impression: Acute COPD Exacerbation Justification for F2 Classification: - Significant respiratory distress with increased work of breathing - Known COPD history with previous exacerbations - Potential for rapid deterioration requiring prompt intervention - Time-sensitive condition requiring immediate medical evaluation and treatment Differential Diagnoses: 1. Acute COPD Exacerbation (high probability) 2. Pneumonia (less likely given rapid onset and wheezing) 3. Pulmonary Embolism (less likely given absence of pleuritic pain) 4. Acute Heart Failure (less likely given absence of edema and known COPD) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration and ventilation support as needed - Bronchodilator administration - Preparation for transport to nearest hospital with respiratory support