Hafnarstræti 18, 600 Akureyri. Ground floor of a two-story commercial building, built in 1965. Main entrance is street level, no steps. No security codes. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6817° N, 18.0883° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe shortness of breath and chest tightness. Patient is conscious but struggling to speak. Skin is pale and clammy. Patient reports a history of COPD and has been feeling unwell for the past 2 days. Symptoms started acutely about 30 minutes ago. He is currently sitting in a chair in his office. Medical history: COPD, hypertension, type 2 diabetes. Medications: Salbutamol inhaler (2 puffs as needed), Fluticasone/Salmeterol inhaler (1 puff twice daily), Metformin 500mg twice daily, Lisinopril 10mg daily. Known allergy to penicillin. Last meal was a sandwich at 12:00.
Timeline: 13:30 hours: Patient reports feeling slightly unwell, mild cough 14:00 hours: Symptoms worsen, increasing shortness of breath 14:15 hours: Patient uses Salbutamol inhaler, no relief 14:20 hours: Patient develops severe shortness of breath and chest tightness 14:30 hours: Patient calls emergency services Prior Events: Patient has a history of COPD exacerbations, with one hospitalization in the past year. He reports having a cold for the last two days. He usually manages his COPD well with his prescribed medications. Last medical check-up was 6 months ago, routine follow-up.
Initial Impression: Acute COPD Exacerbation with Respiratory Distress Justification for F2 Classification: - Acute onset of severe respiratory distress - Patient has a history of COPD, increasing risk of severe exacerbation - Requires urgent medical intervention to prevent respiratory failure Differential Diagnoses: 1. COPD Exacerbation (most likely) 2. Acute Pulmonary Embolism (less likely, no reported leg pain or swelling) 3. Acute Myocardial Infarction (less likely, no reported radiating chest pain) 4. Pneumonia (possible, given recent cold symptoms) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy initiation - Bronchodilator administration - Continuous monitoring of respiratory status - Preparation for transport to nearest hospital with respiratory services