Hafnarstræti 22, 600 Akureyri, ground floor of a two-story wooden building built in 1935. Main entrance faces the street, no stairs. No security features. Parking available on the street. Current conditions: 8°C, overcast, light wind. GPS coordinates: 65.6825° N, 18.0876° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Severe dyspnea, wheezing, use of accessory muscles. Secondary symptoms: Mild chest tightness, anxiety, pale skin. Patient is conscious but struggling to breathe. Patient is sitting upright in a chair. Medical history: COPD diagnosed 5 years ago, hypertension, previous myocardial infarction 2 years ago. Medications: Salbutamol inhaler (as needed), Fluticasone inhaler 250 mcg twice daily, Metoprolol 50mg daily, Aspirin 75mg daily. Allergies: Penicillin. Last meal was a sandwich at 12:00.
Timeline: 1300 hours: Patient felt mild shortness of breath while walking 1315 hours: Shortness of breath worsened, started wheezing 1320 hours: Patient used his salbutamol inhaler, no relief 1325 hours: Patient called his son for help 1330 hours: Son arrived, called emergency services 1332 hours: Current time, patient struggling to breathe, sitting upright. Prior Events: Patient reports several similar episodes in the past year, all managed with inhalers. Last COPD exacerbation 6 months ago, treated with oral steroids. Last medical check-up 2 months ago, routine follow-up. Patient lives alone, but son lives nearby.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Severe respiratory distress with significant symptoms - Patient has a history of COPD and previous exacerbations - Time-sensitive condition requiring prompt medical evaluation and intervention Differential Diagnoses: 1. COPD Exacerbation (high probability) 2. Acute Heart Failure (possible given history of MI) 3. Pneumonia (less likely given absence of fever or cough) 4. Pulmonary Embolism (lower probability, no recent immobilization) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy initiation - Bronchodilator administration - Preparation for transport to nearest hospital with respiratory services