Hafnarstræti 18, 600 Akureyri, second floor. A three-story building with commercial space on the ground floor and apartments above. The building was constructed in 1965. The main entrance is on Hafnarstræti and requires an intercom. There is a staircase but no elevator. Limited street parking. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6822° N, 18.0898° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Significant dyspnea at rest, rapid and shallow breathing, audible wheezing, patient is cyanotic around the lips. Secondary symptoms: Chest tightness, anxiety, productive cough with thick yellow sputum. Patient is conscious but struggling to speak. Medical history: COPD diagnosed 5 years ago, hypertension, previous smoker (quit 10 years ago). Medications: Salbutamol inhaler (as needed), Tiotropium inhaler daily, Amlodipine 10mg daily. Allergies: None reported. Last meal was soup at 12:00.
Timeline: 1400 hours: Patient started feeling mildly short of breath 1415 hours: Shortness of breath worsened, patient used salbutamol inhaler with no relief 1425 hours: Patient developed chest tightness and wheezing 1430 hours: Patient became increasingly distressed, cyanosis noted around the lips 1435 hours: Caller (patient's son) called emergency services 1437 hours: Current time, patient still in severe respiratory distress Prior Events: Patient reports several exacerbations of COPD in the past year, requiring hospital admission. Last COPD check-up 2 months ago, medication adjusted. No recent illnesses or injuries.
Initial Impression: Acute Exacerbation of COPD with Respiratory Distress Justification for F2 Classification: - Significant respiratory distress with cyanosis, indicating potential respiratory failure - Patient has known COPD, increasing the risk of rapid deterioration - 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 reported leg swelling or pain) 4. Acute Heart Failure (less likely, no prior history of heart failure) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration and airway management - Bronchodilator administration - Preparation for transport to nearest hospital with respiratory services