Hafnarstræti 22, 600 Akureyri, ground floor of a two-story wooden building built in 1955. Main entrance at street level. No elevator. Single staircase to the second floor. Street parking available. Building equipped with basic fire extinguishers. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6822° N, 18.0917° W. Nearest landmark: Akureyri Art Museum.
75-year-old male, experiencing severe shortness of breath and chest tightness. Patient is conscious but agitated. Skin is pale and diaphoretic. Patient has a history of COPD and heart failure. Reports a sudden worsening of symptoms over the last 30 minutes. Patient is sitting upright on a chair in his living room. Medical history: COPD diagnosed 15 years ago, heart failure diagnosed 5 years ago, type 2 diabetes. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (twice daily), Furosemide 40mg daily, Metformin 500mg twice daily. Known allergy to penicillin. Last meal was a light lunch at 13:00.
Timeline: 1400 hours: Patient started experiencing mild shortness of breath. 1415 hours: Symptoms worsened rapidly, with increased chest tightness and difficulty breathing. 1420 hours: Patient attempted to use his 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 still experiencing severe respiratory distress. Prior Events: Patient reports several similar episodes in the past year, each requiring medical intervention. Last hospitalization for COPD exacerbation was 6 months ago. No recent infections or other significant changes in health.
Initial Impression: Acute Exacerbation of COPD with possible Heart Failure Decompensation Justification for F2 Classification: - Significant respiratory distress with rapid onset and limited response to bronchodilator - Patient has a history of COPD and heart failure, increasing the risk of serious complications - Time-sensitive condition requiring prompt medical intervention and potential respiratory support Differential Diagnoses: 1. Acute COPD Exacerbation (high probability) 2. Acute Heart Failure (high probability, given history) 3. Pneumonia (less likely given rapid onset, but must be considered) 4. Pulmonary Embolism (less likely but must be considered) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration and respiratory support - Cardiac monitoring and assessment - Preparation for transport to nearest hospital with respiratory and cardiology services