Hafnarstræti 18, 600 Akureyri, third floor apartment 3B. A three-story, older wooden building with a single main entrance and a narrow, steep internal staircase. No elevator. Street parking available, often congested. The building has a basic fire alarm system. Current conditions: 7°C, overcast, light wind. GPS coordinates: 65.6832° N, 18.0912° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Rapid and labored breathing, wheezing, use of accessory muscles, cyanosis around lips. Secondary symptoms: Chest tightness, productive cough with yellow sputum. Patient is conscious but anxious. Medical history: COPD diagnosed 5 years ago, history of smoking, hypertension. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (twice daily), Lisinopril 10mg daily. Allergies: None known. Last meal was a light lunch at 13:00.
Timeline: 1430 hours: Patient began experiencing increased shortness of breath 1440 hours: Symptoms worsened rapidly, with onset of wheezing and cyanosis 1445 hours: Patient attempted to use his salbutamol inhaler with minimal relief 1450 hours: Patient called his son for help 1455 hours: Son arrived and called emergency services 1458 hours: Current time, patient is sitting upright, struggling to breathe. Prior Events: Patient has had several COPD exacerbations in the past year, requiring hospitalizations. He has been compliant with his medications but has not stopped smoking. Last medical check-up 2 months ago, routine follow-up. Patient lives alone but his son lives nearby.
Initial Impression: Acute COPD Exacerbation Justification for F2 Classification: - Significant respiratory distress with cyanosis indicating hypoxemia - Patient's history of COPD and rapid worsening of symptoms suggest a severe exacerbation - Time-sensitive condition requiring prompt oxygen therapy and bronchodilator treatment Differential Diagnoses: 1. COPD Exacerbation (high probability) 2. Pneumonia (possible, given productive cough) 3. Pulmonary Embolism (less likely given chronic history) 4. Acute Heart Failure (less likely given chronic history of COPD) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy administration - Bronchodilator treatment - Preparation for transport to nearest hospital with respiratory support capabilities