Hafnarstræti 18, 600 Akureyri, ground floor of a two-story wooden building constructed in 1950, renovated in 2010. Main entrance at street level, no steps. One back exit to a small parking area. No known security features. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6821° N, 18.0895° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe shortness of breath. Primary symptoms: Difficulty breathing, rapid and shallow respirations, audible wheezing, use of accessory muscles, cyanosis around lips. Secondary symptoms: Agitation, chest tightness, feeling of impending doom. Patient is sitting upright, leaning forward. Medical history: COPD diagnosed 5 years ago, hypertension, type 2 diabetes. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (2 puffs twice daily), Metformin 500mg twice daily, Lisinopril 10mg daily. Known allergy to penicillin. Last meal was a small lunch at 13:00.
Timeline: 1400 hours: Patient felt slightly short of breath, used his salbutamol inhaler with minimal relief 1415 hours: Shortness of breath worsened, patient became agitated 1420 hours: Patient's wife called emergency services 1422 hours: Current time, patient's breathing continues to worsen, now with cyanosis. Prior Events: Patient reports having a mild cold for the past 3 days. No recent hospitalizations or medical procedures. Last COPD exacerbation 6 months ago, treated with oral steroids. Patient is a former smoker (quit 10 years ago).
Initial Impression: Acute Exacerbation of COPD with Respiratory Distress Justification for F2 Classification: - Significant respiratory distress with cyanosis indicates potential for rapid deterioration - Patient requires immediate medical intervention to stabilize breathing - Time-sensitive condition due to potential for respiratory failure Differential Diagnoses: 1. COPD Exacerbation (most likely) 2. Acute Pulmonary Edema (less likely given history) 3. Pneumonia (possible, but less likely given rapid onset) 4. Pulmonary Embolism (less likely given no recent surgery or immobility) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration - Bronchodilator therapy - Continuous monitoring of vital signs - Preparation for transport to hospital with respiratory support