Hafnarstræti 18, 600 Akureyri, third floor apartment 3B. A four-story concrete building constructed in 1968. Main entrance has a coded lock (1974). One elevator and a central stairwell. Street parking available. Building has a fire alarm system. Current conditions: 8°C, overcast, moderate visibility. GPS coordinates: 65.6823° N, 18.0921° W. Nearest landmark: Akureyri Art Museum.
72-year-old male, experiencing severe shortness of breath. Primary symptoms: Severe dyspnea at rest, use of accessory muscles, wheezing, productive cough with yellowish sputum. Secondary symptoms: Chest tightness, anxiety, patient is pale and diaphoretic. Patient is sitting upright, struggling to breathe. Medical history: COPD diagnosed 15 years ago, hypertension, type 2 diabetes. Medications: Salmeterol/Fluticasone inhaler 250/50mcg two puffs twice daily, Tiotropium inhaler 18mcg once daily, Metformin 1000mg twice daily, Lisinopril 10mg daily. Known allergy to penicillin. Last meal was a light lunch at 12:00.
Timeline: 1330 hours: Patient started experiencing increased shortness of breath 1345 hours: Patient used his Salmeterol/Fluticasone inhaler, no relief 1400 hours: Symptoms worsened, patient became anxious and started coughing up yellow phlegm 1410 hours: Patient called his son for help 1415 hours: Son arrived, called emergency services 1418 hours: Current time, patient still experiencing severe respiratory distress Prior Events: Patient had a mild upper respiratory infection last week. No recent hospitalizations. Last medical check-up was 6 months ago, routine follow-up. Patient lives alone, son lives nearby.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Severe respiratory distress with use of accessory muscles and wheezing - Productive cough with yellow sputum indicates possible infection - Time-sensitive condition requiring prompt oxygen therapy and bronchodilator treatment Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 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 treatment - Preparation for transport to nearest hospital with respiratory services