Hafnarstræti 23, 600 Akureyri, ground floor of a two-story wooden building built in 1950, main entrance is accessible via two steps, no elevator. Street parking available. Building has a simple lock. Current conditions: 8°C, clear skies, good visibility. GPS coordinates: 65.6819° N, 18.0912° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe shortness of breath. Primary symptoms: rapid and labored breathing, audible wheezing, cyanosis around the lips. Patient reports sudden onset of symptoms. Secondary symptoms: chest tightness, anxiety, unable to speak in full sentences. Patient is conscious but agitated. Medical history: Chronic Obstructive Pulmonary Disease (COPD) diagnosed 5 years ago, previous hospitalization for exacerbation. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (twice daily), Theophylline 200mg daily. Known allergy: Penicillin. Last meal was a light lunch at 13:00.
Timeline: 14:30 hours: Patient began experiencing mild shortness of breath while resting at home. 14:45 hours: Shortness of breath worsened rapidly, accompanied by wheezing. 14:50 hours: Patient attempted to use his Salbutamol inhaler, with no improvement. 14:55 hours: Patient developed cyanosis around the lips and increased anxiety. Caller contacted emergency services. 15:00 hours: Current time, patient is still experiencing severe respiratory distress. Prior Events: Patient has had several exacerbations of COPD in the past year, requiring treatment with oral corticosteroids. No recent illnesses. Last medical check-up 2 months ago, routine follow-up. Patient lives alone, but his son lives nearby.
Initial Impression: Acute COPD Exacerbation with Severe Respiratory Distress Justification for F2 Classification: - Patient presents with significant respiratory distress, indicating a potential life threat. - Presence of cyanosis suggests hypoxemia, requiring urgent intervention. - History of COPD and recent exacerbation increases risk of deterioration. Differential Diagnoses: 1. Acute COPD Exacerbation (high probability) 2. Pneumonia (less likely without fever, but should be considered) 3. Pulmonary Embolism (less likely given the gradual onset, but possible) 4. Acute Heart Failure (less likely given no history of cardiac disease) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy initiation - Continuous monitoring of respiratory status - Preparation for possible intubation - Rapid transport to hospital with respiratory support facilities