Hafnarstræti 23, 600 Akureyri, first floor, apartment 103. A three-story mixed-use building constructed in 1968, with commercial units on the ground floor and residential apartments above. Main entrance accessible via street level, no elevator. Emergency access from the rear via a narrow alleyway. Building has basic fire safety measures. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6837° N, 18.0917° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing acute onset of severe shortness of breath. Primary symptoms: Labored breathing, wheezing, chest tightness, productive cough with yellow sputum. Secondary symptoms: Mild cyanosis around lips, increased heart rate, anxiety. Patient is conscious but agitated. Patient sitting upright in a chair in his living room. Medical history: COPD diagnosed 5 years ago, hypertension. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (2 puffs 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 progressively worsened, developing into severe dyspnea and wheezing 1440 hours: Patient attempted to use his salbutamol inhaler without significant relief 1445 hours: Patient called his son for help 1450 hours: Son arrived, called emergency services 1452 hours: Current time, patient is still struggling to breathe, sitting upright Prior Events: Patient has had several exacerbations of COPD in the past year, requiring hospitalization once 6 months ago. Reports a recent cold for the past 3 days. No recent changes to medication. Last medical check-up 2 months ago, routine follow-up.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Significant respiratory distress with potential for rapid deterioration - Patient has known COPD with recent cold symptoms - Requires prompt medical intervention to stabilize respiratory status Differential Diagnoses: 1. Acute Exacerbation of COPD (most likely) 2. Pneumonia (possible given recent cold) 3. Pulmonary Embolism (less likely, no reported chest pain) 4. Acute Heart Failure (less likely, no history of heart failure) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration and assisted ventilation if needed - Bronchodilator therapy initiation - Preparation for transport to nearest hospital with respiratory services