Hafnarstræti 22, 600 Akureyri, Ground floor of a 2-story wooden building constructed in 1955. Main entrance is at street level, no stairs. Single door access. No security features. Weather: 7°C, clear skies, good visibility. GPS coordinates: 65.6821° N, 18.0912° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing sudden onset of severe chest pain. Primary symptoms: Crushing chest pain radiating to left arm and jaw, shortness of breath, diaphoresis. Patient is pale and anxious. Secondary symptoms: Nausea, dizziness. Patient is conscious but distressed. Medical history: Hypertension, type 2 diabetes, hyperlipidemia. Medications: Metformin 1000mg twice daily, Atorvastatin 20mg daily, Lisinopril 20mg daily. Known allergy to penicillin. Last meal was a sandwich at 11:00.
Timeline: 1215 hours: Patient experienced sudden onset of severe chest pain while walking home from the grocery store. 1216 hours: Patient sat down on a bench and called his son. 1218 hours: Patient's son arrived, patient reported worsening chest pain and shortness of breath. 1220 hours: Son called emergency services. 1222 hours: Current time, patient is still seated on the bench, conscious but distressed. Prior Events: Patient reports occasional mild chest discomfort over the past few months, but nothing this severe. Last medical check-up 6 months ago, routine follow-up. Patient has a history of smoking but quit 5 years ago. No recent illnesses or injuries.
Initial Impression: Suspected Acute Coronary Syndrome (ACS), likely Myocardial Infarction Justification for F2 Classification: - High probability of cardiac event based on classic symptoms (crushing chest pain, radiation, diaphoresis) - Patient's medical history increases risk for ACS - Time-sensitive condition requiring rapid intervention to minimize myocardial damage Differential Diagnoses: 1. Myocardial Infarction (high probability) 2. Unstable Angina (less likely given severity of pain) 3. Aortic Dissection (less likely given lack of tearing pain) 4. Pulmonary Embolism (less likely given lack of pleuritic pain) Required Actions: - Dispatch of ground EMS with ALS capabilities - Immediate ECG acquisition and interpretation - Pain management protocols initiation - Oxygen administration - Preparation for transport to nearest hospital with cardiac catheterization lab