Hafnarstræti 22, 600 Akureyri, third floor, apartment 3B. A five-story concrete building constructed in 1995. Main entrance has a coded lock, code is 1973. Elevator and central stairwell available. Street parking available. Building is equipped with a fire alarm system. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6838° N, 18.0878° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Difficulty breathing, wheezing, productive cough with yellowish sputum, chest tightness. Patient reports feeling anxious and lightheaded. Secondary symptoms: Mild cyanosis around lips. Patient is conscious but appears distressed. Medical history: COPD diagnosed 5 years ago, type 2 diabetes, hypertension. Medications: Salbutamol inhaler (2 puffs as needed), Tiotropium inhaler (1 puff daily), Metformin 500mg twice daily, Lisinopril 10mg daily. Allergies: Sulfa drugs. Last meal: Lunch at 13:00, a sandwich. Smoker: 20 pack years.
Timeline: 1400 hours: Patient started feeling slightly short of breath. 1430 hours: Shortness of breath worsened, started coughing. 1445 hours: Cough became productive with yellowish sputum, chest tightness developed. 1450 hours: Patient reports feeling lightheaded, became anxious. 1455 hours: Patient called his son for help. 1500 hours: Son arrived, called emergency services. 1502 hours: Current time, patient is sitting upright, struggling to breathe. Prior Events: Patient has had multiple exacerbations of COPD in the past year, requiring hospitalizations. Last hospital visit was 3 months ago for a similar episode. Patient has been compliant with his medications. No recent changes in health status until today. Last medical check-up 2 months ago.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Significant respiratory distress with potential for rapid deterioration - Patient has underlying COPD with known history of exacerbations - Presence of wheezing, productive cough, and cyanosis indicate severe respiratory compromise - Time-sensitive condition requiring immediate intervention Differential Diagnoses: 1. Acute Exacerbation of COPD (most likely) 2. Pneumonia (possible, given productive cough) 3. Pulmonary Embolism (less likely, no reported chest pain) 4. Acute Heart Failure (less likely, no reported leg swelling) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration and monitoring - Bronchodilator administration - Preparation for transport to nearest hospital with respiratory services