Hafnarstræti 18, 600 Akureyri, first floor, apartment 101. A three-story, older wooden building constructed in 1948. Main entrance is street-level with a small step. No elevator. Stairwell access only. Street parking available. No known security features. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6831° N, 18.0938° W. Nearest landmark: Akureyri Art Museum.
72-year-old male, experiencing severe shortness of breath. Primary symptoms: Marked dyspnea, wheezing, productive cough with yellow sputum. Patient is sitting upright, struggling to breathe. Secondary symptoms: Mild chest tightness, anxiety, pale skin. Patient is conscious but agitated. Medical history: COPD diagnosed 5 years ago, history of smoking, hypertension. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (twice daily), Lisinopril 10mg daily. Known allergy to penicillin. Last meal was a light lunch at 12:00. Oxygen saturation measured by caller at 88% using personal pulse oximeter.
Timeline: 1300 hours: Patient reports feeling slightly unwell, mild cough. 1330 hours: Cough worsens, patient begins experiencing shortness of breath. 1345 hours: Shortness of breath increases rapidly, patient uses Salbutamol inhaler with minimal relief. 1350 hours: Patient’s son calls emergency services. 1355 hours: Current time, patient sitting upright, struggling to breathe, oxygen saturation 88%. Prior Events: Patient has had several exacerbations of COPD in the past year, requiring hospital admissions. Last hospital admission was 6 months ago. Patient has been compliant with medication regime. No recent travel or exposure to respiratory illnesses.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Patient experiencing significant respiratory distress, with oxygen saturation below 90% - History of COPD and recent exacerbations indicates potential for rapid deterioration - Time-sensitive condition requiring prompt medical intervention and oxygen therapy Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pneumonia (less likely given no fever) 3. Pulmonary Embolism (less likely given absence of sudden onset pleuritic chest pain) 4. Acute Heart Failure (less likely given no history of heart failure and primary respiratory symptoms) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration via nasal cannula or mask - Bronchodilator therapy if appropriate - Continuous monitoring of vital signs - Preparation for transport to nearest hospital with respiratory support