Hafnarstræti 18, 600 Akureyri, ground floor, apartment 1B. Two-story wooden building built in 1955. Main entrance has a single wooden door with a standard lock. No elevator. Street parking available. Building is equipped with smoke detectors. Current conditions: 8°C, overcast, light breeze. GPS coordinates: 65.6823° N, 18.0921° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe shortness of breath. Primary symptoms: severe dyspnea, wheezing, productive cough with yellowish sputum, cyanosis around lips. Secondary symptoms: chest tightness, anxiety, diaphoresis. Patient is conscious but agitated. Patient sitting upright in a chair, struggling to breathe. Medical history: COPD diagnosed 5 years ago, hypertension, type 2 diabetes. Medications: Salbutamol inhaler (2 puffs PRN), Fluticasone/Salmeterol inhaler (1 puff BID), Metformin 500mg BID, Lisinopril 10mg daily. Allergies: Penicillin. Last meal was a light lunch at 13:00. Patient reports feeling unwell since yesterday evening.
Timeline: 1700 hours: Patient began feeling more short of breath than usual. 1800 hours: Patient used his salbutamol inhaler, with minimal relief. 1900 hours: Symptoms worsened, developed a productive cough with yellow sputum. 1930 hours: Patient started feeling anxious and developed chest tightness. 1945 hours: Patient called his son for help. 1950 hours: Son arrived and called emergency services. Current time, patient is still struggling to breathe. Prior Events: Patient had a similar episode 3 months ago, treated with oral steroids and antibiotics. Patient reports not taking his medications as prescribed for the last week. Recent cold symptoms for the last 3 days.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Moderate respiratory distress with signs of hypoxia (cyanosis) - Patient has a known history of COPD and is experiencing a significant worsening of symptoms - Time-sensitive condition requiring prompt medical intervention to prevent respiratory failure Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pneumonia (possible, given productive cough) 3. Pulmonary Embolism (less likely given gradual onset) 4. Acute Heart Failure (less likely, no history of heart failure) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy administration - Bronchodilator administration (nebulized salbutamol) - IV access and monitoring of vital signs - Preparation for transport to nearest hospital with respiratory support