Hafnarstræti 18, 600 Akureyri, third floor apartment 3B. Five-story concrete building constructed in 1995. Main entrance with intercom system. Elevator and central stairwell. Street parking available. Building has a fire alarm system. Current conditions: 7°C, overcast, moderate visibility. GPS coordinates: 65.6810° N, 18.0912° W. Nearest landmark: Akureyri Art Museum.
78-year-old male, experiencing severe shortness of breath. Primary symptoms: Labored breathing, wheezing, chest tightness. Secondary symptoms: Mild confusion, cyanosis around lips. Patient is conscious but appears distressed. Patient is sitting upright in a chair. Medical history: COPD diagnosed 5 years ago, hypertension, previous myocardial infarction 2 years ago. Medications: Salbutamol inhaler (as needed), Beclomethasone inhaler (2 puffs twice daily), Ramipril 5mg daily, Aspirin 75mg daily. Allergies: Penicillin. Last meal was a light lunch at 12:00.
Timeline: 1400 hours: Patient reports feeling increasingly short of breath 1410 hours: Symptoms worsen, patient becomes more distressed 1415 hours: Patient uses salbutamol inhaler, no improvement 1420 hours: Caller (patient's son) arrives, notices patient's condition 1425 hours: Current time, caller initiates emergency call Prior Events: Patient had a mild upper respiratory infection last week, resolved without antibiotics. No recent changes in medication. Patient has been compliant with medication regimen. Reports moderate physical activity daily.
Initial Impression: Acute Exacerbation of COPD with Respiratory Distress Justification for F2 Classification: - Significant respiratory distress with labored breathing and wheezing - Potential for rapid deterioration and respiratory failure - Time-sensitive condition requiring immediate medical intervention Differential Diagnoses: 1. Acute Exacerbation of COPD (most likely) 2. Pulmonary Embolism (less likely given absence of sudden onset) 3. Acute Heart Failure (possible given prior MI, but less likely than COPD exacerbation) 4. Pneumonia (possible, but less likely given absence of fever) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration and continuous monitoring - Bronchodilator treatment (nebulized if available) - Preparation for transport to nearest hospital with respiratory care services