Hafnarstræti 18, 600 Akureyri, third floor apartment 3B. A five-story reinforced concrete building built in 1995. Main entrance has a coded lock, code is 2468. There is one elevator and a central staircase. Street parking is available. Building has a fire suppression system. Current conditions: 7°C, overcast, moderate wind. GPS coordinates: 65.6823° N, 18.0889° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing acute shortness of breath. Primary symptoms: Severe dyspnea, rapid and shallow breathing, audible wheezing, cyanosis around lips. Patient reports feeling like he is suffocating. Secondary symptoms: Chest tightness, anxiety, productive cough with clear sputum. Patient is conscious but distressed. Medical history: Chronic obstructive pulmonary disease (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. Allergies: Penicillin. Last meal was a light lunch at 13:00.
Timeline: 1430 hours: Patient reports onset of mild shortness of breath while resting 1445 hours: Symptoms worsen rapidly, including wheezing and chest tightness 1450 hours: Patient attempts to use salbutamol inhaler with minimal relief 1455 hours: Patient calls his son for help 1500 hours: Son arrives and calls emergency services 1502 hours: Current time, patient still experiencing severe respiratory distress Prior Events: Patient has had several COPD exacerbations in the past year, requiring hospitalization twice. Last medical check-up 2 months ago, routine follow-up. Patient lives alone, but son lives nearby.
Initial Impression: Acute COPD Exacerbation with Severe Respiratory Distress Justification for F2 Classification: - High risk of respiratory failure given severe dyspnea, wheezing, and cyanosis - Time-sensitive condition requiring immediate medical intervention and oxygen therapy - Potential for rapid deterioration and need for advanced airway management Differential Diagnoses: 1. COPD Exacerbation (high probability) 2. Acute Pulmonary Edema (less likely given history) 3. Pulmonary Embolism (less likely given gradual onset) 4. Pneumonia (possible, needs further assessment) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy administration - Bronchodilator administration - Preparation for transport to nearest hospital with respiratory services