Hafnarstræti 18, 600 Akureyri, third floor apartment 3B. Five-story concrete residential building constructed in 1995. Main entrance has a key code, currently 1234. Elevator and central stairwell available. Street parking and a small parking lot behind the building. Building equipped with smoke detectors. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6827° N, 18.0885° W. Nearest landmark: Akureyri Art Museum.
62-year-old male, experiencing severe shortness of breath. Primary symptoms: Difficulty breathing, wheezing, productive cough with yellow sputum, chest tightness. Secondary symptoms: Increased heart rate, anxiety, slight cyanosis around lips. Patient is conscious but distressed, sitting upright in a chair. 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. Known allergy to penicillin. Last meal was a light lunch at 13:00.
Timeline: 1400 hours: Patient began experiencing mild shortness of breath. 1430 hours: Shortness of breath worsened, accompanied by wheezing and cough. 1445 hours: Patient used Salbutamol inhaler, with minimal relief. 1500 hours: Patient's condition continues to deteriorate, chest tightness and cyanosis noted. Caller (patient's son) called emergency services. 1505 hours: Current time, patient is sitting upright, struggling to breathe. Prior Events: Patient had a COPD exacerbation 3 months ago, treated with oral steroids and antibiotics. Patient reports non-compliance with regular inhaler use over the last week. Patient has had a mild cold for the past 3 days.
Initial Impression: Acute COPD Exacerbation with Respiratory Distress Justification for F2 Classification: - Moderate respiratory distress, with signs of hypoxemia (cyanosis) - History of COPD, indicating a high risk for rapid deterioration - Failure to respond to initial bronchodilator treatment - Time-sensitive condition requiring prompt medical intervention Differential Diagnoses: 1. COPD Exacerbation (high probability) 2. Pneumonia (possible, given productive cough) 3. Acute Bronchitis (less likely due to chronic history) 4. Pulmonary Embolism (less likely, no specific risk factors) 5. Acute Heart Failure (less likely, no history of heart failure) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy administration - Bronchodilator administration - Preparation for transport to nearest hospital with respiratory services