Hafnarstræti 22, 600 Akureyri, ground floor of a two-story wooden building, built in 1950. Main entrance at street level. No elevator. One main entrance/exit. No security features. Current conditions: 7°C, overcast, moderate visibility, dry road conditions. GPS coordinates: 65.6823° 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, audible wheezing, cyanosis around lips. Patient reports feeling anxious and unable to speak in full sentences. Secondary symptoms: Chest tightness, productive cough with yellow sputum. Patient is conscious but appears distressed. Patient is sitting upright in a chair. Medical history: Chronic obstructive pulmonary disease (COPD) diagnosed 5 years ago, hypertension. Medications: Salbutamol inhaler (2 puffs as needed), Beclomethasone inhaler (2 puffs twice daily), Lisinopril 10mg daily. Known allergy: Penicillin. Last meal was a light lunch at 12:00.
Timeline: 1330 hours: Patient began experiencing increased shortness of breath 1340 hours: Patient used salbutamol inhaler, with minimal improvement 1350 hours: Patient's breathing worsened, developed chest tightness 1355 hours: Patient coughed up yellow sputum 1400 hours: Patient's son called emergency services 1403 hours: Current time, patient still experiencing severe respiratory distress Prior Events: Patient has had several COPD exacerbations in the past year, requiring hospitalizations. Last medical check-up 2 months ago, routine follow-up. Patient lives with his son.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Significant respiratory distress, potential for rapid deterioration - Audible wheezing and cyanosis indicating hypoxemia - Time-sensitive condition requiring prompt medical intervention Differential Diagnoses: 1. COPD Exacerbation (high probability) 2. Pneumonia (possible given productive cough) 3. Pulmonary Embolism (less likely given chronic history) 4. Acute Heart Failure (less likely given lack of edema) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration and monitoring - Bronchodilator administration - Preparation for transport to nearest hospital