Hafnarstræti 77, 600 Akureyri, first floor. A two-story wooden building constructed in 1948, with a small business on the ground floor and apartments above. Main entrance on the street, no elevator. Street parking available. Current conditions: 7°C, cloudy, good visibility. GPS coordinates: 65.6819° N, 18.0878° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: severe dyspnea, wheezing, productive cough with yellowish sputum, chest tightness. Secondary symptoms: anxiety, mild cyanosis around lips. Patient is conscious but distressed. Patient sitting upright on a chair. Medical history: COPD diagnosed 5 years ago, hypertension, type 2 diabetes. Medications: Salbutamol inhaler (2 puffs as needed), Fluticasone inhaler (2 puffs daily), Metformin 1000mg twice daily, Lisinopril 10mg daily. Known allergy: penicillin. Last meal was a light lunch at 13:00. Patient reports feeling unwell for the past 3 days with worsening symptoms.
Timeline: 1300 hours: Patient ate a light lunch, felt generally unwell. 1500 hours: Patient started experiencing mild shortness of breath and cough. 1700 hours: Symptoms worsened, patient used salbutamol inhaler with minimal relief. 1800 hours: Patient's breathing became more labored, cough productive with yellow sputum. 1815 hours: Patient's son arrived, found him in distress, called emergency services. 1820 hours: Current time, patient is sitting up, severely short of breath. Prior Events: Patient has had multiple COPD exacerbations in the past. He was hospitalized 6 months ago for a similar episode. Patient had a flu vaccine 2 months ago. No recent travel or exposure to unusual substances. Patient lives with his wife, who is currently out of town.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Severe respiratory distress, indicating potential airway compromise. - Patient has a history of COPD, increasing the risk of rapid deterioration. - Symptoms include dyspnea, wheezing, and productive cough, consistent with an exacerbation. - Time-sensitive condition requiring prompt medical intervention. Differential Diagnoses: 1. Acute Exacerbation of COPD (most likely) 2. Pneumonia (possible, given productive cough) 3. Pulmonary Embolism (less likely, no sudden onset of chest pain) 4. Acute Heart Failure (less likely, no history of heart failure) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy initiation - Bronchodilator administration - Preparation for transport to nearest hospital with respiratory services