Hafnarstræti 18, 600 Akureyri. Ground floor of a two-story wooden building constructed in 1930. Main entrance has a single door with no security features. Street parking available. Current conditions: 8°C, overcast, light breeze. GPS coordinates: 65.6822° N, 18.0898° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe shortness of breath. Primary symptoms: Rapid, labored breathing, wheezing, use of accessory muscles. Secondary symptoms: Cyanosis around lips, increased heart rate, anxiety. Patient is conscious but agitated. Patient sitting upright in a chair. Medical history: COPD diagnosed 5 years ago, history of smoking, no known allergies. Medications: Salbutamol inhaler (2 puffs as needed), Tiotropium inhaler (1 puff daily), Prednisone 5mg daily. Last meal was lunch at 13:00.
Timeline: 1500 hours: Patient started feeling short of breath, initially mild 1515 hours: Symptoms worsened rapidly, patient began wheezing 1520 hours: Patient used salbutamol inhaler, no relief 1525 hours: Patient's breathing became labored, developed cyanosis 1528 hours: Caller (patient's son) called emergency services 1530 hours: Current time, patient still experiencing severe respiratory distress Prior Events: Patient has had several COPD exacerbations in the past year, requiring hospitalization twice. Last medical check-up 2 months ago, routine follow-up. Patient lives with his son.
Initial Impression: Severe COPD Exacerbation Justification for F2 Classification: - Acute respiratory distress with signs of hypoxemia (cyanosis) - Patient not responding to usual bronchodilator treatment - Risk of rapid deterioration requiring prompt medical intervention Differential Diagnoses: 1. COPD Exacerbation (high probability) 2. Acute Asthma Exacerbation (less likely given history) 3. Pulmonary Embolism (possible, but less likely given lack of chest pain) 4. Pneumonia (possible, but less likely given rapid onset) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration and continuous monitoring - Bronchodilator therapy (nebulized if available) - Preparation for transport to nearest hospital