Hafnarstræti 22, 600 Akureyri, third floor apartment 3B. A five-story reinforced concrete building, constructed in 1995. Main entrance has a keypad lock (code: 1978). Elevator and central stairwell available. Street parking on Hafnarstræti. Building is equipped with smoke detectors and a sprinkler system. Current conditions: 8°C, overcast, light wind, good visibility. GPS coordinates: 65.6821° N, 18.0923° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe shortness of breath. Primary symptoms: Difficulty breathing, rapid and shallow respirations, wheezing, chest tightness. Secondary symptoms: Anxiety, pale skin, sweating. Patient is conscious but distressed. Medical history: COPD diagnosed 5 years ago, hypertension, type 2 diabetes. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (twice daily), Metformin 500mg (twice daily), Lisinopril 10mg (daily). Known allergy to penicillin. Last meal was a light lunch at 13:00.
Timeline: 1415 hours: Patient started experiencing mild shortness of breath 1430 hours: Symptoms worsened, patient used his salbutamol inhaler with minimal relief 1440 hours: Patient's breathing became increasingly difficult, developed chest tightness and wheezing 1445 hours: Patient called his son for help 1450 hours: Son arrived, called emergency services 1452 hours: Current time, patient is sitting upright, struggling to breathe Prior Events: Patient has had several COPD exacerbations in the past year, requiring hospitalization. Last hospitalization was 6 months ago. Patient reports he has not had any recent infections. Last medical check-up 2 months ago, routine follow-up. Patient lives with his wife.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Patient presenting with severe respiratory distress, requiring immediate medical intervention - History of COPD and recent symptom exacerbation indicates a high risk condition - Time-sensitive condition requiring prompt assessment and treatment Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pneumonia (possible, but less likely without fever) 3. Pulmonary Embolism (less likely given absence of sudden onset and pleuritic chest pain) 4. Acute Heart Failure (possible, but less likely given chronic history of COPD) Required Actions: - Dispatch of ground EMS with ALS capabilities - Administration of supplemental oxygen - Monitoring of vital signs - Bronchodilator administration (if indicated) - Preparation for transport to nearest hospital with respiratory services