Hafnarstræti 18, 600 Akureyri, first floor. Two-story wooden building, built in 1930, with a main entrance facing the street. No elevator. Street parking is available. The building has a basic fire alarm system. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6823° N, 18.0916° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe shortness of breath. Primary symptoms: Labored breathing, wheezing, chest tightness. Secondary symptoms: Anxiety, mild cyanosis around lips. Patient is conscious but struggling to speak in full sentences. Patient is sitting upright in a chair in his living room. Medical history: Chronic obstructive pulmonary disease (COPD) diagnosed 5 years ago, hypertension. Medications: Salbutamol inhaler (as needed), Fluticasone inhaler (twice daily), Lisinopril 10mg daily. Known allergy: Sulfa drugs. Last meal was a light lunch at 12:00.
Timeline: 1400 hours: Patient started feeling mild shortness of breath 1415 hours: Shortness of breath worsened, developed wheezing 1420 hours: Patient used his salbutamol inhaler, with minimal relief 1425 hours: Symptoms continued to worsen, developed chest tightness 1430 hours: Patient called emergency services Prior Events: Patient has had several COPD exacerbations in the past, usually managed at home with increased inhaler use. Last COPD flare-up was 3 months ago, treated with oral steroids. No recent infections or fever. Patient lives alone. Last medical check-up 6 months ago, routine follow-up.
Initial Impression: Acute COPD Exacerbation Justification for F2 Classification: - Significant respiratory distress with wheezing and cyanosis - History of COPD requiring prompt intervention - Time-sensitive condition requiring oxygen and medication administration Differential Diagnoses: 1. Acute COPD Exacerbation (high probability) 2. Acute Bronchitis (less likely given history of COPD) 3. Pulmonary Embolism (less likely, no sudden onset of chest pain) 4. Pneumonia (less likely, no fever or recent illness) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy initiation - Bronchodilator administration - Preparation for transport to nearest hospital with respiratory services