Hafnarstræti 22, 600 Akureyri. Ground floor of a two-story wooden building, built in 1935. Main entrance at street level, no stairs. No elevator. Street parking available. Building has a basic fire alarm. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6821° N, 18.0919° W. Nearest landmark: Akureyri Art Museum.
35-year-old male experiencing severe shortness of breath, wheezing, and chest tightness. Patient reports a history of asthma, but this episode is worse than usual. Patient is pale, diaphoretic, and using accessory muscles to breathe. He is sitting upright, struggling to speak in full sentences. Initial pulse is 118 bpm, respiratory rate 30, SpO2 90% on room air. Patient is alert but anxious. No known allergies. Medications: Salbutamol inhaler (Ventolin) as needed, Fluticasone inhaler (Flovent) twice daily. Last dose of Salbutamol 10 minutes prior to call with minimal relief. Last meal was a light lunch at 13:00.
Timeline: 1400 hours: Patient began experiencing mild shortness of breath and wheezing. 1415 hours: Symptoms worsened rapidly, leading to severe respiratory distress. 1420 hours: Patient self-administered Salbutamol inhaler, with minimal improvement. 1425 hours: Patient called emergency services. 1427 hours: Current time, patient is in severe respiratory distress. Prior Events: Patient has a history of asthma since childhood, usually well-controlled with medication. No recent upper respiratory infection or other triggers identified. No prior hospitalizations for asthma in the last 2 years. Patient has been compliant with his prescribed medications. No recent travel.
Initial Impression: Severe Asthma Exacerbation Justification for F2 Classification: - Acute onset of severe respiratory distress, with signs of hypoxia and accessory muscle use. - Patient has a history of asthma, increasing the likelihood of a severe exacerbation. - Time-sensitive condition requiring prompt medical intervention to prevent respiratory failure. Differential Diagnoses: 1. Severe Asthma Exacerbation (high probability) 2. Acute Bronchitis (less likely given history and severity) 3. Pneumothorax (less likely given absence of chest pain or trauma) 4. Pulmonary Embolism (less likely given absence of sudden onset pleuritic pain) Required Actions: - Dispatch of ground EMS with ALS capabilities - Administration of oxygen via non-rebreather mask - Consider nebulized bronchodilators (e.g., Salbutamol, Ipratropium) - Preparation for transport to nearest hospital with respiratory support capabilities