Hafnarstræti 23, 600 Akureyri, ground floor of a two-story commercial building. Main entrance has a single door with a small step. No elevator. Building constructed in 1960. Street parking available. Current conditions: 7°C, clear skies, good visibility. GPS coordinates: 65.6810° N, 18.0920° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Rapid and labored breathing, audible wheezing, use of accessory muscles, cyanosis around lips. Secondary symptoms: Increased heart rate, anxiety, inability to speak in full sentences. Patient is sitting upright in a chair, pale and sweating. History of COPD, currently using a home oxygen concentrator. Medications: Salbutamol inhaler (as needed), Tiotropium inhaler (daily), Prednisolone 5mg daily, Oxygen 2L via nasal cannula. No known allergies. Last meal was a light lunch at 13:00.
Timeline: 14:30 hours: Patient began feeling slightly short of breath 14:45 hours: Shortness of breath worsened rapidly, patient started using his salbutamol inhaler with minimal relief 15:00 hours: Patient's breathing became more labored, started feeling anxious 15:05 hours: Patient called his son, who then called emergency services 15:10 hours: Current time, patient is struggling to breathe, cyanotic around lips Prior Events: Patient has a history of COPD, managed with inhalers and home oxygen. He has had several exacerbations in the past but none requiring hospitalization in the last 6 months. Last medical check-up 2 months ago, routine follow-up. Lives alone, son lives nearby.
Initial Impression: Acute Exacerbation of COPD with Respiratory Distress Justification for F2 Classification: - Severe respiratory distress with cyanosis, indicating potential hypoxemia - Patient's history of COPD and rapid symptom progression - Need for immediate oxygen therapy and potential pharmacological intervention - Time-sensitive condition requiring prompt medical evaluation Differential Diagnoses: 1. Acute COPD Exacerbation (high probability) 2. Pneumonia (possible, needs further assessment) 3. Pulmonary Embolism (less likely, no chest pain reported) 4. Acute Heart Failure (less likely, no reported history of cardiac issues) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration via non-rebreather mask - Assessment of vital signs and respiratory status - Preparation for potential intubation if needed - Transport to nearest hospital with respiratory care services