Hafnarstræti 18, 600 Akureyri, third floor apartment 3B. Four-story concrete building constructed in 1965. Main entrance with buzzer system. Elevator and central stairwell. Limited street parking. Building has a fire sprinkler system. Current conditions: 8°C, cloudy, good visibility. GPS coordinates: 65.6812° N, 18.0932° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Labored breathing, audible wheezing, chest tightness. Secondary symptoms: Increased heart rate, anxiety, pale skin. Patient is conscious but struggling to speak. Patient is sitting upright in a chair. Medical history: Chronic obstructive pulmonary disease (COPD), hypertension, Type 2 diabetes. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (twice daily), Metformin 500mg twice daily, Lisinopril 10mg daily. Known allergies: Penicillin. Last meal: Light lunch at 12:00.
Timeline: 1300 hours: Patient started experiencing mild shortness of breath. 1315 hours: Shortness of breath worsened, accompanied by wheezing. 1320 hours: Patient attempted to use salbutamol inhaler, no significant relief. 1325 hours: Patient’s condition continues to deteriorate, chest tightness reported. 1330 hours: Current time, patient is in significant respiratory distress, called emergency services. Prior Events: Patient reports frequent COPD exacerbations, typically managed at home with increased inhaler use. Last COPD exacerbation was 2 months ago. No recent changes in medications. Last medical check-up was 1 month ago, routine follow-up. Patient lives alone.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Significant respiratory distress with labored breathing and wheezing - Patient's medical history of COPD - Lack of response to initial inhaler use - Time-sensitive condition requiring prompt intervention to prevent further respiratory failure Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pneumonia (less likely given no reported fever or productive cough) 3. Pulmonary Embolism (less likely given no history of recent surgery or prolonged immobility) 4. Acute Heart Failure (less likely given known history of COPD) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration - Bronchodilator administration - Preparation for transport to nearest hospital with respiratory services