Hafnarstræti 19, 600 Akureyri, first floor of a two-story commercial building, converted to residential. Main entrance is on the street level, no elevator. Built in 1955, concrete structure. No security features. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6823° N, 18.0915° W. Nearest landmark: Hof Cultural and Conference Center.
78-year-old male, experiencing severe shortness of breath. Primary symptoms: Labored breathing, wheezing, use of accessory muscles. Secondary symptoms: Chest tightness, lightheadedness, cyanosis around lips. Patient is conscious but agitated. Medical history: Chronic obstructive pulmonary disease (COPD), hypertension, type 2 diabetes. Medications: Salbutamol inhaler (2 puffs as needed), Seretide inhaler (2 puffs twice daily), Metformin 500mg twice daily, Lisinopril 10mg daily. Allergies: Penicillin. Last meal was a small lunch at 13:00.
Timeline: 1500 hours: Patient started feeling mildly short of breath 1515 hours: Symptoms worsened, patient used salbutamol inhaler with minimal relief 1530 hours: Symptoms continued to worsen, patient began experiencing chest tightness 1540 hours: Patient called his son for help 1545 hours: Son arrived, called emergency services 1548 hours: Current time, patient is struggling to breathe, cyanotic around the lips Prior Events: Patient has a history of COPD exacerbations, last hospitalization 6 months ago for similar symptoms. No recent infections or fevers. Patient lives alone, son lives nearby.
Initial Impression: Acute COPD Exacerbation with Respiratory Distress Justification for F2 Classification: - Severe respiratory distress with signs of hypoxia (cyanosis) - Patient has known COPD, high risk for rapid deterioration - Time-sensitive condition requiring immediate medical intervention Differential Diagnoses: 1. COPD Exacerbation (most likely) 2. Acute Pulmonary Embolism (less likely, no recent surgery or immobility) 3. Pneumonia (less likely, no reported fever or productive cough) 4. Acute Heart Failure (less likely, no history of heart failure) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration and monitoring - Bronchodilator therapy (nebulized salbutamol/ipratropium) - Preparation for transport to nearest hospital with respiratory support