Hafnarstræti 21, 600 Akureyri, ground floor of a two-story wooden building, built in 1950. Main entrance on the street level. No elevator. One main entrance/exit. No security features. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6818° N, 18.0910° W. Nearest landmark: Akureyri Art Museum.
62-year-old male, experiencing severe shortness of breath. Primary symptoms: Labored breathing, audible wheezing, patient is using accessory muscles to breathe, cyanosis around the lips. Secondary symptoms: Patient is anxious, reports chest tightness, unable to speak in full sentences. Patient is conscious but agitated. Medical history: Asthma diagnosed in childhood, COPD diagnosed 5 years ago, history of smoking. Medications: Salbutamol inhaler (2 puffs as needed), Fluticasone inhaler (2 puffs daily), Tiotropium inhaler (1 puff daily). Allergies: None known. Last meal was a light lunch at 13:00.
Timeline: 1415 hours: Patient began feeling increasingly short of breath 1420 hours: Patient used his salbutamol inhaler with minimal relief 1425 hours: Symptoms worsened, patient started wheezing 1430 hours: Patient called his son for help 1432 hours: Son arrived, found patient in distress, called emergency services 1435 hours: Current time, patient is still struggling to breathe, son is with him. Prior Events: Patient reports having a cold for the past three days. He has been using his inhalers more frequently. No recent hospitalizations. Last medical check-up 6 months ago, routine follow-up for COPD.
Initial Impression: Acute Asthma Exacerbation/COPD Exacerbation Justification for F2 Classification: - Significant respiratory distress with signs of airway obstruction - Patient's medical history includes asthma and COPD, increasing risk - Cyanosis indicates hypoxemia, requiring urgent intervention - Time-sensitive condition requiring prompt medical evaluation and treatment Differential Diagnoses: 1. Acute Asthma Exacerbation (high probability given history) 2. COPD Exacerbation (high probability given history) 3. Pneumonia (less likely without fever, but cannot be ruled out) 4. Pulmonary Embolism (less likely given gradual onset) 5. Acute Heart Failure (less likely, no history of heart disease) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration and respiratory support - Continuous monitoring of vital signs - Preparation for transport to nearest hospital with respiratory services