Hafnarstræti 18, 600 Akureyri. Ground floor of a two-story wooden building built in 1930. Main entrance is at street level, no stairs. One exit at the rear leading to a small courtyard. No security system. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6818° N, 18.0879° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe shortness of breath. Primary symptoms: Labored breathing, wheezing, productive cough with yellowish sputum. Patient is sitting upright, struggling to breathe. Secondary symptoms: Chest tightness, cyanosis around lips. Patient is alert but anxious. Medical history: COPD diagnosed 5 years ago, history of smoking (quit 2 years ago), type 2 diabetes. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (twice daily), Metformin 1000mg twice daily. Known allergy: Penicillin. Last meal was a light lunch at 12:00.
Timeline: 1300 hours: Patient started feeling unwell, mild cough. 1330 hours: Cough worsened, shortness of breath began. 1400 hours: Patient used Salbutamol inhaler, no improvement. 1415 hours: Shortness of breath increased, chest tightness developed. 1420 hours: Patient called emergency services. 1422 hours: Current time, patient still experiencing severe respiratory distress. Prior Events: Patient reports several similar episodes in the past year, requiring hospitalization. Last hospital visit was 6 months ago for a COPD exacerbation. Patient has been compliant with medications, reports no recent illnesses.
Initial Impression: Acute COPD Exacerbation Justification for F2 Classification: - Patient experiencing severe respiratory distress with cyanosis - History of COPD and recent exacerbations - Condition is time-sensitive, requiring prompt intervention Differential Diagnoses: 1. Acute COPD Exacerbation (most likely) 2. Pneumonia (possible, given productive cough) 3. Pulmonary Embolism (less likely, no sudden onset of symptoms) 4. Acute Heart Failure (less likely, no significant history of heart disease) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy initiation - Bronchodilator administration - Preparation for transport to nearest hospital with respiratory services