Hafnarstræti 18, 600 Akureyri, ground floor, commercial building, built in 1955, renovated in 2010. Main entrance faces Hafnarstræti, secondary entrance from back alley. No elevator, single-story building. Street parking available. Building has a basic fire alarm system. Current conditions: 8°C, overcast, good visibility, dry roads. GPS coordinates: 65.6812° N, 18.0897° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe shortness of breath. Primary symptoms: Difficulty breathing, rapid and shallow respirations, audible wheezing, chest tightness. Secondary symptoms: Mild cyanosis around lips, anxious and agitated. Patient is conscious but struggling to speak. Patient found sitting in a chair in his office. Medical history: Chronic obstructive pulmonary disease (COPD), hypertension, type 2 diabetes. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (twice daily), Metformin 500mg twice daily, Lisinopril 10mg daily. Allergies: Penicillin. Last meal was a light lunch at 12:00.
Timeline: 1310 hours: Patient started feeling shortness of breath 1315 hours: Symptoms worsened rapidly, patient began wheezing 1318 hours: Patient attempted to use salbutamol inhaler, no relief 1320 hours: Patient called his colleague for help 1322 hours: Colleague called emergency services 1323 hours: Current time, patient still struggling to breathe Prior Events: Patient reports a COPD exacerbation 3 months ago, treated with oral steroids. Patient has been compliant with his medications. No recent respiratory infections. Last medical check-up 2 months ago, routine follow-up. Patient is a smoker, approximately 10 cigarettes per day.
Initial Impression: Acute COPD Exacerbation with Respiratory Distress Justification for F2 Classification: - Significant respiratory distress with rapid onset and severity - Audible wheezing, cyanosis, and patient distress indicate potential for rapid deterioration - Time-sensitive condition requiring immediate intervention to prevent respiratory failure Differential Diagnoses: 1. COPD Exacerbation (high probability) 2. Acute Asthma Attack (less likely given history) 3. Pulmonary Embolism (lower probability, no chest pain) 4. Pneumonia (lower probability, no fever or productive cough) 5. Acute Heart Failure (lower probability, no history of heart disease) Required Actions: - Dispatch of ground EMS with ALS capabilities - Supplemental oxygen administration - Bronchodilator administration (nebulizer if available) - Monitoring of vital signs and level of consciousness - Preparation for transport to nearest hospital with respiratory support