Hafnarstræti 73, 600 Akureyri, ground floor of a two-story wooden building, built in 1955. Main entrance faces the street, no security system. Street parking available. Current conditions: 8°C, overcast, moderate wind. GPS coordinates: 65.6821° N, 18.0899° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe shortness of breath. Primary symptoms: Significant dyspnea, wheezing, use of accessory muscles for breathing, cyanosis around the lips. Secondary symptoms: Increased heart rate, anxiety, productive cough with yellow sputum. Patient is conscious but agitated. Medical history: COPD diagnosed 5 years ago, hypertension, type 2 diabetes. Medications: Salbutamol inhaler (2 puffs as needed), Fluticasone inhaler (1 puff twice daily), Metformin 500mg twice daily, Lisinopril 10mg daily. Allergies: Penicillin. Last meal was a sandwich at 12:00.
Timeline: 1300 hours: Patient began experiencing mild shortness of breath 1315 hours: Symptoms worsened, patient used his salbutamol inhaler with minimal relief 1330 hours: Patient started to feel very anxious and called his son for help 1335 hours: Son arrived, patient now visibly struggling to breathe, cyanotic 1340 hours: Son called emergency services 1342 hours: Current time, patient is sitting upright, struggling to breathe Prior Events: Patient reports several COPD exacerbations in the past year, last hospitalization 6 months ago. Recent upper respiratory infection 2 weeks ago. Patient reports compliance with his medications. No recent changes in medication or health status other than the recent infection.
Initial Impression: Acute COPD Exacerbation with Respiratory Distress Justification for F2 Classification: - Patient is experiencing significant respiratory distress with cyanosis and accessory muscle use - History of COPD and recent infection increases risk of rapid deterioration - Time-sensitive condition requiring immediate intervention to prevent respiratory failure Differential Diagnoses: 1. COPD Exacerbation (high probability) 2. Pneumonia (possible, given recent infection) 3. Pulmonary Embolism (less likely given symptoms) 4. Acute Heart Failure (less likely given no history of cardiac issues) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy initiation - Bronchodilator administration - Monitoring of vital signs and respiratory status - Preparation for transport to nearest hospital with respiratory support