Hafnarstræti 18, 600 Akureyri, first floor of a two-story wooden building, built in 1950. Main entrance facing the street, no elevator, one internal staircase. Street parking available. Building has a basic fire alarm system. Current conditions: 7°C, overcast, light wind, good visibility. GPS coordinates: 65.6837° N, 18.0902° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Rapid, labored breathing, productive cough with yellowish sputum, chest tightness. Secondary symptoms: Increased heart rate, pale skin, anxiety. Patient is conscious but struggling to speak in full sentences. 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. Allergies: Penicillin. Last meal was a light lunch at 12:00.
Timeline: 1300 hours: Patient started feeling unwell, mild cough and slight shortness of breath. 1330 hours: Symptoms worsened, increased coughing and breathing difficulty. 1400 hours: Patient reports feeling very tight in the chest, coughing up yellow phlegm, using his rescue inhaler with no relief. 1415 hours: Patient called his son, who then called emergency services. 1420 hours: Current time, patient is sitting up in a chair, struggling to breathe. Prior Events: Patient had a COPD exacerbation 3 months ago, treated with oral steroids and antibiotics. Patient reports being compliant with medications. No recent travel or exposure to known respiratory illnesses. Last medical check-up 2 months ago, routine follow-up.
Initial Impression: Acute COPD Exacerbation Justification for F2 Classification: - Significant respiratory distress with increased work of breathing - Patient has a history of COPD, increasing the likelihood of acute exacerbation - Symptoms indicate a need for prompt intervention to prevent respiratory failure Differential Diagnoses: 1. Acute COPD Exacerbation (high probability) 2. Pneumonia (possible, given productive cough) 3. Pulmonary Embolism (less likely, no reported risk factors) 4. Acute Heart Failure (less likely, no history of cardiac issues) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration and monitoring - Bronchodilator administration - Preparation for transport to nearest hospital with respiratory services