Hafnarstræti 18, 600 Akureyri, ground floor of a two-story wooden building, built in 1955. Main entrance on the street level, no steps. No elevator. Building has a fire alarm system. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6823° N, 18.0912° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Labored breathing, chest tightness, cyanosis around lips, and audible wheezing. Patient is conscious but agitated. Secondary symptoms: Mild confusion, rapid pulse. Patient is sitting upright in a chair. Medical history: COPD diagnosed 5 years ago, hypertension, type 2 diabetes. Medications: Salbutamol inhaler (as needed), Tiotropium inhaler (daily), Metformin 500mg twice daily, Amlodipine 5mg daily. Allergies: Penicillin. Last meal was lunch at 13:00.
Timeline: 1430 hours: Patient began feeling slightly short of breath 1445 hours: Shortness of breath worsened, developed chest tightness 1450 hours: Patient used his salbutamol inhaler, with minimal relief 1455 hours: Patient's condition continued to deteriorate, wife called emergency services 1458 hours: Current time, patient is struggling to breathe, wife reports he is turning blue Prior Events: Patient has had several exacerbations of COPD in the past, last hospitalization was 6 months ago. Patient reports increased sputum production in the last 2 days. Last medical check-up 2 weeks ago, routine follow-up. Patient lives with his wife.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Patient is experiencing significant respiratory distress, with signs of cyanosis - Condition is time-sensitive and requires immediate medical intervention - Risk of rapid deterioration Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pulmonary Embolism (less likely, no reported chest pain) 3. Pneumonia (less likely, no reported fever) 4. Acute Heart Failure (less likely, no reported history of heart failure) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy initiation - Monitoring of vital signs and respiratory status - Preparation for transport to nearest hospital with respiratory services