Hafnarstræti 23, 600 Akureyri. Ground floor of a two-story wooden building, built in 1952. Main entrance is street-level with a single door. No elevator. Street parking is available. Building has basic security with a standard lock. Current weather conditions: 7°C, overcast, light wind. GPS coordinates: 65.6831° N, 18.0879° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Difficulty breathing, rapid and shallow respirations, audible wheezing, pale skin. Secondary symptoms: Chest tightness, mild confusion. Patient is conscious but anxious. Medical history: COPD (Chronic Obstructive Pulmonary Disease) diagnosed 5 years ago, hypertension, type 2 diabetes. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (1 puff twice daily), Metformin 500mg twice daily, Lisinopril 10mg daily. Allergies: None known. Last meal was a light lunch at 13:00. Patient was sitting in his living room when symptoms started.
Timeline: 1415 hours: Patient began experiencing mild shortness of breath while watching television. 1420 hours: Symptoms worsened, with increased difficulty breathing and chest tightness. 1425 hours: Patient used his Salbutamol inhaler, with minimal relief. 1428 hours: Patient called his son, Jónas, for help. 1430 hours: Jónas arrived and called emergency services. 1432 hours: Current time, patient is still experiencing severe respiratory distress. Prior Events: Patient has had several COPD exacerbations in the past year, with one hospital admission 3 months ago. Patient reports a recent mild cold but no fever. Has been compliant with his medications. Last medical check-up 2 months ago, routine follow-up. Patient lives alone, son lives nearby.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Patient experiencing severe respiratory distress with signs of hypoxia - History of COPD with previous exacerbations - Time-sensitive condition requiring prompt medical intervention Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pneumonia (less likely given no fever or productive cough) 3. Pulmonary Embolism (less likely given no sudden onset of chest pain) 4. Acute Heart Failure (less likely given no history of heart failure) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration and respiratory support - Assessment for potential need for advanced airway management - Preparation for transport to nearest hospital with respiratory services