Hafnarstræti 18, 600 Akureyri. Ground floor commercial space, single-story building, built in 1965, concrete structure. Main entrance is a single door facing the street, no other access points. No security features. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6810° N, 18.0920° W. Nearest landmark: Hof Cultural and Conference Center.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Rapid, labored breathing, use of accessory muscles, cyanosis around lips. Secondary symptoms: Agitation, chest tightness, productive cough with yellow sputum. Patient is conscious but appears distressed. Medical history: COPD diagnosed 5 years ago, history of smoking, hypertension. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (twice daily), Lisinopril 10mg daily. Known allergy to penicillin. Last meal was a light lunch at 13:00.
Timeline: 1400 hours: Patient began feeling slightly short of breath, attributed it to usual COPD. 1415 hours: Symptoms worsened, patient used salbutamol inhaler with minimal relief. 1430 hours: Patient developed a productive cough, shortness of breath became severe, patient became agitated. 1435 hours: Caller, patient's son, called emergency services. 1440 hours: Current time, patient is struggling to breathe, cyanotic, and coughing frequently. Prior Events: Patient has had several COPD exacerbations in the past year, requiring hospitalizations. Last COPD flare-up was 2 months ago. No recent changes in medications. Patient was seen by his primary care physician 1 week ago for a routine check-up.
Initial Impression: Acute Exacerbation of COPD with Respiratory Distress Justification for F2 Classification: - Patient is experiencing severe respiratory distress with signs of hypoxemia (cyanosis) - Time-sensitive condition requiring immediate intervention to prevent respiratory failure - Patient has a history of COPD, increasing the risk of rapid deterioration Differential Diagnoses: 1. COPD Exacerbation (most likely) 2. Pneumonia (possible, given productive cough) 3. Pulmonary Embolism (less likely, no reported chest pain) 4. Acute Heart Failure (less likely, no history of heart failure) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy initiation - Medication administration (bronchodilators, corticosteroids) - Continuous monitoring of vital signs - Preparation for transport to nearest hospital with respiratory services