Hafnarstræti 18, 600 Akureyri, third floor apartment 3B. Five-story reinforced concrete building constructed in 1992. Main entrance requires key code, elevator and stairwell access. Street parking available. Building equipped with fire suppression system. Current conditions: 7°C, overcast, light wind. GPS coordinates: 65.6822° N, 18.0889° W. Nearest landmark: Akureyri Art Museum.
62-year-old male, experiencing severe shortness of breath and chest tightness. Patient is conscious but distressed, speaking in short sentences. Primary symptoms: severe dyspnea, wheezing, productive cough with yellow sputum. Secondary symptoms: cyanosis around lips, increased heart rate, sweating. Patient is sitting upright, leaning forward, using accessory muscles to breathe. Patient has a history of COPD, uses an inhaler. Medical history: COPD diagnosed 5 years ago, hypertension, type 2 diabetes. Medications: Salbutamol inhaler as needed, Beclomethasone inhaler twice daily, Metformin 1000mg twice daily, Lisinopril 10mg daily. Allergies: No known allergies. Last meal was a light lunch at 13:00.
Timeline: 1400 hours: Patient started feeling slightly short of breath. 1430 hours: Symptoms worsened rapidly, developed chest tightness and wheezing. 1440 hours: Patient started coughing up yellow sputum. 1445 hours: Patient called his son for help, son called emergency services. 1448 hours: Current time, patient is struggling to breathe, sitting upright. Prior Events: Patient has had several COPD exacerbations in the past, treated with oral steroids and antibiotics. Last exacerbation was 3 months ago. Last medical check-up 2 months ago, routine follow-up. Patient lives alone, son lives nearby.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Severe respiratory distress with significant dyspnea, wheezing, and cyanosis - High probability of respiratory failure requiring immediate medical intervention - Time-sensitive condition requiring prompt oxygen therapy and bronchodilator administration Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pneumonia (possible given productive cough) 3. Pulmonary Embolism (less likely given history and symptoms) 4. Acute Heart Failure (less likely given no history of heart failure) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy administration - Bronchodilator administration - Preparation for transport to nearest hospital with respiratory support