Hafnarstræti 22, 600 Akureyri, ground floor of a two-story wooden building, built in 1950, main entrance faces the street, no elevator, one set of stairs to second floor, street parking, no security features, current conditions: 8°C, overcast, light breeze, good visibility. GPS coordinates: 65.6812° N, 18.0923° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Difficulty breathing, rapid and shallow respirations, chest tightness, use of accessory muscles. Secondary symptoms: Mild cyanosis around lips, anxious and agitated, unable to speak in full sentences. Patient is sitting upright in a chair. Medical history: COPD diagnosed 5 years ago, hypertension, type 2 diabetes. Medications: Salbutamol inhaler (as needed), Tiotropium inhaler daily, Metformin 500mg twice daily, Lisinopril 10mg daily. Allergies: Sulfa drugs. Last meal was a small lunch at 13:00.
Timeline: 1400 hours: Patient reports mild shortness of breath while resting 1415 hours: Symptoms worsen rapidly, patient becomes increasingly distressed 1420 hours: Patient attempts to use salbutamol inhaler with minimal relief 1425 hours: Patient called his son for help 1430 hours: Son arrived and called emergency services 1432 hours: Current time, patient is struggling to breathe, sitting upright Prior Events: Patient reports several exacerbations of COPD in the past year, requiring hospitalization. Last medical check-up was 2 weeks ago, routine follow-up. Patient lives alone, but son lives nearby.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Significant respiratory distress with rapid onset and progression - Use of accessory muscles, cyanosis, and difficulty speaking - Patient's known history of COPD with prior exacerbations - Time-sensitive condition requiring prompt medical intervention Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pulmonary Embolism (less likely given gradual onset) 3. Pneumonia (less likely given no reported fever or productive cough) 4. Acute Heart Failure (less likely given no reported leg edema or orthopnea) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy administration - Bronchodilator administration - Preparation for transport to nearest hospital with respiratory support