Hafnarstræti 22, 600 Akureyri, ground floor of a two-story commercial building. Built in 1965, brick construction. Main entrance faces the street, one back entrance with loading dock. No elevator. Street parking available. Fire alarm system present. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6818° N, 18.0911° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Rapid and labored breathing, wheezing, chest tightness, cyanosis around lips. Secondary symptoms: Agitation, diaphoresis, inability to speak in full sentences. Patient is sitting upright in a chair, appearing very distressed. Medical history: COPD diagnosed 5 years ago, hypertension, type 2 diabetes. Medications: Salbutamol inhaler (as needed), Seretide inhaler (2 puffs twice daily), Metformin 500mg twice daily, Lisinopril 10mg daily. Allergies: None known. Last meal was lunch at 13:00, a light sandwich.
Timeline: 1500 hours: Patient started feeling slightly short of breath while walking home from the store 1515 hours: Symptoms worsened, patient began using his salbutamol inhaler, no relief 1520 hours: Patient’s breathing became very labored, developed chest tightness, became cyanotic 1525 hours: Caller (patient's son) arrived home, found patient in distress, called emergency services 1528 hours: Current time, patient is still struggling to breathe, unable to speak much Prior Events: Patient has had several COPD exacerbations in the past year, requiring hospital admission. No recent infections. Last medical check-up 2 months ago, routine follow-up. Patient lives with his son.
Initial Impression: Acute COPD Exacerbation with Respiratory Distress Justification for F2 Classification: - Significant respiratory distress with cyanosis, indicating potential respiratory failure - Patient's history of COPD exacerbations and current severe symptoms suggest a high-risk condition - Time-sensitive condition requiring immediate oxygen administration and possible airway management Differential Diagnoses: 1. COPD Exacerbation (high probability) 2. Acute Pulmonary Embolism (less likely, no history of DVT or recent surgery) 3. Acute Heart Failure (less likely, no history of heart failure) 4. Pneumonia (less likely, no fever or productive cough reported) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration with high flow rate - Bronchodilator therapy if available - Preparation for intubation if condition deteriorates - Rapid transport to hospital