Hafnarstræti 9, 600 Akureyri, ground floor of a two-story wooden building built in 1950. Main entrance faces the street, no stairs, one exit to the back alley. No security features. Current conditions: 7°C, overcast, good visibility, dry roads. GPS coordinates: 65.6823° N, 18.0901° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Difficulty breathing, wheezing, chest tightness. Secondary symptoms: Increased heart rate, pale skin, mild confusion. Patient is sitting upright in a chair. 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 small lunch at 13:00.
Timeline: 1400 hours: Patient started feeling slightly short of breath. 1415 hours: Shortness of breath worsened, patient used his Salbutamol inhaler with minimal relief. 1420 hours: Patient began experiencing chest tightness and increased wheezing. 1425 hours: Patient's son called emergency services. 1427 hours: Current time, patient is still struggling to breathe. Prior Events: Patient has had several COPD exacerbations in the past year, requiring hospital admission. Last COPD-related hospitalization was 6 months ago. Recent upper respiratory infection 2 weeks ago, but symptoms had resolved. Patient reports no recent changes in medication or diet.
Initial Impression: Acute COPD Exacerbation Justification for F2 Classification: - Patient experiencing significant respiratory distress with signs of hypoxia - History of COPD with previous exacerbations - Time-sensitive condition requiring prompt medical intervention Differential Diagnoses: 1. Acute COPD Exacerbation (high probability) 2. Pneumonia (less likely, no reported fever or productive cough) 3. Pulmonary Embolism (less likely, no sudden onset of sharp chest pain) 4. Acute Heart Failure (less likely, no reported leg swelling or orthopnea) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy administration - Bronchodilator therapy initiation - Preparation for transport to nearest hospital with respiratory services