Hafnarstræti 77, 600 Akureyri, third floor apartment 3B. A four-story concrete building built in 1968. The main entrance is accessible via a coded lock (code 2345). There is an elevator and a central staircase. Street parking is available. Building has a fire alarm system. Current weather: 7°C, overcast, light wind. Visibility is good. GPS coordinates: 65.6812° N, 18.0900° W. Nearest landmark: Akureyri Art Museum.
67-year-old male, experiencing severe shortness of breath. Primary symptoms: Labored breathing, chest tightness, wheezing, and cyanosis around the lips. Secondary symptoms: Increased heart rate, anxiety, and dizziness. Patient is conscious but struggling to speak in full sentences. Patient is sitting upright on a chair in his living room. Medical history: COPD diagnosed 5 years ago, history of smoking, hypertension, and type 2 diabetes. Medications: Salbutamol inhaler (2 puffs PRN), Fluticasone/Salmeterol inhaler (1 puff BID), Metformin 500mg BID, Lisinopril 10mg daily. Known allergy: Penicillin. Last meal was a small lunch at 13:00.
Timeline: 14:00 hours: Patient started feeling slightly short of breath 14:15 hours: Shortness of breath worsened, patient used his Salbutamol inhaler with no relief 14:20 hours: Patient developed chest tightness and wheezing 14:25 hours: Patient's breathing became labored and he felt dizzy 14:28 hours: Caller (patient's son) arrived and called emergency services 14:30 hours: Current time, patient is struggling to breathe, cyanotic around the lips Prior Events: Patient reports an exacerbation of COPD symptoms over the last 2 days, has not been feeling well, and has had increased cough. Patient has not been compliant with his medications regularly. Last medical check-up was 6 months ago, routine follow-up. Patient lives alone, son lives nearby.
Initial Impression: Severe COPD Exacerbation with Respiratory Distress Justification for F2 Classification: - Significant respiratory distress indicated by labored breathing, wheezing, and cyanosis. - High risk of rapid deterioration without intervention - Time-sensitive condition requiring immediate oxygen and bronchodilator treatment Differential Diagnoses: 1. Acute COPD Exacerbation (most likely) 2. Pulmonary Embolism (less likely, no reported chest pain) 3. Pneumonia (possible, needs further assessment) 4. Acute Heart Failure (less likely, no reported leg swelling or orthopnea) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration - Bronchodilator treatment - Preparation for transport to nearest hospital with respiratory care facilities