Hafnarstræti 78, 600 Akureyri, first floor of a two-story wooden building built in 1950. Main entrance faces the street, no elevator. Street parking available. Building has basic fire safety equipment. Current conditions: 7°C, overcast, moderate visibility. GPS coordinates: 65.6828° N, 18.0884° W. Nearest landmark: Akureyri Art Museum.
72-year-old male, experiencing severe shortness of breath. Primary symptoms: Rapid, labored breathing, audible wheezing, chest tightness. Patient reports feeling anxious and unable to get enough air. Secondary symptoms: Mild cyanosis around lips, productive cough with clear sputum. Patient is alert but distressed. Skin is pale and clammy. Patient sitting upright on a chair in his living room. Medical history: COPD diagnosed 5 years ago, hypertension, type 2 diabetes. Medications: Salbutamol inhaler (2 puffs as needed), Fluticasone inhaler (1 puff daily), Metformin 500mg twice daily, Lisinopril 10mg daily. Known allergy to penicillin. Last meal was a light lunch at 12:30.
Timeline: 1400 hours: Patient started feeling slightly short of breath, attributed to normal COPD 1415 hours: Shortness of breath worsened, patient used salbutamol inhaler with minimal relief 1420 hours: Symptoms continued to worsen, chest tightness developed 1425 hours: Patient called his son for help, who is now calling emergency services 1428 hours: Current time, patient is struggling to breathe, still sitting upright Prior Events: Patient reports several COPD exacerbations in the past year, treated with oral steroids and antibiotics. No recent hospitalizations. Last medical check-up 2 months ago, routine follow-up. Patient lives alone, but his son lives nearby.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Significant respiratory distress with potential for rapid deterioration - Patient using accessory muscles for breathing, cyanosis present - Time-sensitive condition requiring prompt medical intervention Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pneumonia (consider based on productive cough) 3. Pulmonary Embolism (less likely given chronic condition) 4. Acute Heart Failure (less likely given no reported chest pain) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy initiation - Bronchodilator administration - Preparation for transport to nearest hospital with respiratory services