Hafnarstræti 18, 600 Akureyri, first floor apartment 1B. A three-story wooden building built in 1955. Main entrance has a coded lock (1972). No elevator, stairwell access only. Street parking is available. The building is equipped with a smoke alarm system. Current conditions: 7°C, cloudy, good visibility. GPS coordinates: 65.6833° N, 18.0889° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Marked dyspnea, audible wheezing, rapid breathing, and productive cough with yellow sputum. Secondary symptoms: Chest tightness, mild cyanosis around lips, and reported feeling of panic. Patient is sitting upright, struggling to breathe. Medical history: Chronic obstructive pulmonary disease (COPD) diagnosed 8 years ago, type 2 diabetes. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (1 puff twice daily), Metformin 500mg twice daily. Allergies: Penicillin. Last meal was a light lunch at 13:00.
Timeline: 1430 hours: Patient began to experience increased shortness of breath and coughing 1440 hours: Patient used his salbutamol inhaler, with minimal relief 1450 hours: Patient's breathing worsened, began to cough up yellow phlegm, felt chest tightness 1455 hours: Caller, patient's son, arrived at the apartment and called emergency services 1500 hours: Current time, patient is struggling to breathe, cyanosis noted around lips Prior Events: Patient has had several exacerbations of COPD in the past year, requiring hospitalization. Last hospital visit was 6 months ago for a similar episode. Patient reports feeling slightly unwell for the past two days with a mild cough, but no fever. No recent changes to his medication regimen. Patient lives alone, son lives nearby.
Initial Impression: Acute Exacerbation of COPD with Possible Respiratory Infection Justification for F2 Classification: - Significant respiratory distress with potential for rapid deterioration - Patient is symptomatic, exhibiting signs of hypoxia (cyanosis) - Time-sensitive condition requiring prompt medical intervention and oxygen support Differential Diagnoses: 1. Acute COPD Exacerbation (high probability) 2. Pneumonia (likely given productive cough and yellow sputum) 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 administration initiation - Bronchodilator therapy administration - Preparation for transport to nearest hospital with respiratory services