Hafnarstræti 22, 600 Akureyri, ground floor of a two-story wooden building constructed in 1935. Main entrance has a small step. No elevator. Street parking available. Building is equipped with a basic fire alarm. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6821° N, 18.0898° W. Nearest landmark: Akureyri Art Museum.
45-year-old male, experiencing severe shortness of breath. Primary symptoms: Significant wheezing, labored breathing, use of accessory muscles. Secondary symptoms: Increased heart rate, mild cyanosis around lips, anxiety. Patient is conscious but distressed, speaking in short sentences. Patient is sitting upright in his living room. Medical history: Asthma diagnosed in childhood, previous hospitalizations for asthma exacerbations. Allergies: Dust mites, pollen. Medications: Salbutamol inhaler (2 puffs as needed, last used 15 minutes ago), Fluticasone inhaler (2 puffs daily), Montelukast 10mg daily. Last meal was a light lunch at 13:00.
Timeline: 1415 hours: Patient began experiencing increased shortness of breath 1420 hours: Patient used his Salbutamol inhaler, with minimal relief 1425 hours: Symptoms worsened, patient developed significant wheezing and difficulty speaking 1430 hours: Patient's partner called emergency services 1432 hours: Current time, patient is still struggling to breathe, sitting upright Prior Events: Patient reports a recent cold last week that has been lingering. He has been feeling more tired than usual. He denies any recent changes to his medication routine. He has been exposed to more dust than usual due to home renovations.
Initial Impression: Acute Asthma Exacerbation Justification for F2 Classification: - Significant respiratory distress with wheezing, labored breathing, and accessory muscle use - Patient has a history of asthma with previous hospitalizations - Symptoms are not resolving with initial bronchodilator use - Time-sensitive condition requiring prompt medical intervention to prevent respiratory failure Differential Diagnoses: 1. Acute Asthma Exacerbation (high probability) 2. Anaphylaxis (less likely given no known allergen exposure and gradual onset) 3. Pneumonia (less likely given no fever or cough) 4. Pulmonary Embolism (less likely given no chest pain or sudden onset) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration - Bronchodilator therapy (nebulized salbutamol/ipratropium) - Corticosteroid administration - Continuous monitoring of respiratory status and vital signs