Hafnarstræti 75, 600 Akureyri. Ground floor commercial building, approximately 40 years old, concrete construction. Main entrance faces the street, no security features. Street parking available. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6833° N, 18.0922° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe shortness of breath. Primary symptoms: Labored breathing, wheezing, productive cough with yellow sputum. Secondary symptoms: Chest tightness, mild cyanosis around lips. Patient is conscious but anxious. Patient sitting upright, leaning forward. Medical history: COPD diagnosed 5 years ago, 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 reports feeling increasingly short of breath 1415 hours: Patient used Salbutamol inhaler, no relief 1420 hours: Symptoms worsen, patient develops wheezing and productive cough 1425 hours: Patient calls emergency services 1427 hours: Current time, patient is still in distress, unable to speak in full sentences Prior Events: Patient has had several COPD exacerbations in the past year, requiring hospitalization twice. No recent illnesses or injuries. Last medical check-up 2 months ago, routine follow-up. Patient lives with his wife, who is present at the scene.
Initial Impression: Acute COPD Exacerbation Justification for F2 Classification: - Significant respiratory distress with wheezing and productive cough - Patient's history of COPD and recent exacerbations - Potential for rapid deterioration if not promptly treated - Requires immediate medical attention and possible respiratory support Differential Diagnoses: 1. Acute COPD Exacerbation (high probability) 2. Pneumonia (less likely without fever, but cannot rule out) 3. Pulmonary Embolism (less likely, no chest pain or risk factors) 4. Acute Heart Failure (less likely, no reported edema or JVD) 5. Upper Airway Obstruction (less likely, patient is able to speak) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy and nebulized bronchodilator administration - Monitoring of respiratory status and vital signs - Preparation for transport to nearest hospital