Hafnarstræti 18, 600 Akureyri. Ground floor of a two-story wooden building, built in 1930. Main entrance at street level, no steps. No elevator. Street parking available. Building equipped with basic fire alarm. Current conditions: 7°C, clear skies, good visibility. GPS coordinates: 65.6835° N, 18.0882° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe shortness of breath. Primary symptoms: Rapid, labored breathing, wheezing, use of accessory muscles. Secondary symptoms: Chest tightness, cyanosis around lips, patient is anxious and struggling to speak in full sentences. Patient is sitting upright, leaning forward. Medical history: Chronic obstructive pulmonary disease (COPD), diagnosed 5 years ago. Medications: Salbutamol inhaler (2 puffs as needed), Fluticasone/Salmeterol inhaler (1 puff twice daily), Prednisone 5mg daily. Allergies: Penicillin. Last meal was a light lunch at 12:00. Patient is at home.
Timeline: 1300 hours: Patient started feeling slightly short of breath 1315 hours: Shortness of breath worsened, started wheezing 1320 hours: Patient used Salbutamol inhaler, no improvement 1325 hours: Patient called his son for help 1330 hours: Son arrived, called emergency services 1332 hours: Current time, patient in significant respiratory distress Prior Events: Patient reports a history of exacerbations of COPD, last hospitalization 6 months ago. Patient has been compliant with his medications. No recent respiratory infections. Patient is a former smoker, quit 10 years ago.
Initial Impression: Acute COPD Exacerbation Justification for F2 Classification: - Significant respiratory distress with cyanosis and accessory muscle use - High risk of respiratory failure if not treated promptly - Time-sensitive condition requiring immediate medical intervention Differential Diagnoses: 1. Acute COPD Exacerbation (high probability) 2. Pneumonia (less likely given no fever reported) 3. Pulmonary Embolism (less likely given history and presentation) 4. Acute Heart Failure (less likely given absence of leg edema or JVD) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration - Bronchodilator therapy - Preparation for transport to nearest hospital with respiratory services