Hafnarstræti 18, 600 Akureyri, ground floor. Two-story wooden building, built in 1920, recently renovated. Main entrance is on the street level with a small step. No elevator. Street parking available. Building has a basic fire alarm system. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6825° N, 18.0901° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Difficulty breathing, rapid and shallow respirations, wheezing, cyanosis around lips. Patient reports feeling like he is suffocating. Secondary symptoms: Chest tightness, anxiety, productive cough with clear sputum. Patient is conscious but appears distressed. Patient is sitting upright in a chair. Medical history: COPD diagnosed 5 years ago, hypertension. Medications: Salbutamol inhaler PRN, Tiotropium inhaler daily, Lisinopril 10mg daily, Atorvastatin 20mg daily. Allergies: Penicillin. Last meal was a light lunch at 13:00. Patient has had a cold for the last 3 days.
Timeline: 1500 hours: Patient started feeling increased shortness of breath 1510 hours: Patient used his Salbutamol inhaler with no relief 1515 hours: Symptoms worsened, patient started wheezing and coughing 1520 hours: Patient called his son for help 1525 hours: Son arrived, called emergency services 1528 hours: Current time, patient is struggling to breathe Prior Events: Patient has had several exacerbations of COPD in the past year. Last hospitalization for COPD was 6 months ago. Patient reports increased sputum production and worsening cough for the last 3 days. He reports being compliant with his medications.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - High probability of respiratory compromise with potential for rapid deterioration - Patient is symptomatic with increased work of breathing, wheezing, and cyanosis - Time-sensitive condition requiring prompt medical intervention Differential Diagnoses: 1. Acute Exacerbation of COPD (most likely) 2. Pneumonia (possible, given recent cold) 3. Pulmonary Embolism (less likely, no risk factors reported) 4. Acute Heart Failure (less likely, no history of heart disease) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy initiation - Bronchodilator administration - Preparation for transport to nearest hospital with respiratory services