Hafnarstræti 18, 600 Akureyri. Ground floor of a two-story wooden building constructed in 1955. Main entrance accessible from the street. No elevator, single interior stairwell. Street parking available. Building has no special security features. Current conditions: 7°C, overcast, light breeze, good visibility. GPS coordinates: 65.6829° N, 18.0895° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Rapid, labored breathing, audible wheezing, unable to speak in full sentences, using accessory muscles to breathe. Secondary symptoms: Pale, slightly cyanotic around the lips, sweating, appears anxious. Patient is sitting upright in a chair. Medical history: COPD diagnosed 5 years ago, hypertension, type 2 diabetes. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (twice daily), Metformin 500mg (twice daily), Lisinopril 10mg (daily). Allergies: Penicillin. Last meal was a small lunch at 12:30. No recent fever or cough reported. No recent changes to medication.
Timeline: 1400 hours: Patient reports feeling slightly short of breath, initially attributed to mild exertion. 1415 hours: Shortness of breath progressively worsened, started using his salbutamol inhaler, with no relief. 1420 hours: Breathing became more labored, started to feel dizzy and anxious. 1425 hours: Patient contacted his son, who called emergency services immediately. 1428 hours: Current time, patient is sitting in a chair, struggling to breathe, unable to speak more than a few words at a time. Prior Events: Patient has had several exacerbations of COPD in the past, requiring hospitalizations. Last COPD flare-up was 6 months ago. No recent infections or travel. Last medical check-up was 2 months ago, routine follow-up. Patient lives alone, but his son lives nearby.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Patient exhibiting signs of severe respiratory distress, including use of accessory muscles, cyanosis, and inability to speak in full sentences. - High probability of respiratory failure without immediate intervention. - Time-sensitive condition requiring prompt oxygen therapy and possible advanced airway management. Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pulmonary Embolism (less likely given chronic history of COPD) 3. Acute Heart Failure (possible, given history of hypertension) 4. Pneumonia (less likely, no fever or productive cough) 5. Anaphylaxis (unlikely, no known exposure to allergens) Required Actions: - Dispatch of ground EMS with ALS capabilities. - Oxygen therapy initiation. - Continuous monitoring of respiratory status and level of consciousness. - Preparation for possible intubation and mechanical ventilation. - Rapid transport to nearest hospital with respiratory services.