Hafnarstræti 76, 600 Akureyri, third floor apartment 3B. Five-story concrete building constructed in 1995. Main entrance has a key code and intercom system. Elevator and central stairwell access. Street parking available. Building has a fire alarm system and sprinklers. Current conditions: 7°C, clear skies, good visibility. GPS coordinates: 65.6822° N, 18.0923° W. Nearest landmark: Akureyri Art Museum.
75-year-old male, experiencing severe shortness of breath. Primary symptoms: Difficulty breathing, rapid and shallow respirations, use of accessory muscles. Patient reports feeling 'suffocated'. Secondary symptoms: Chest tightness, mild cyanosis around lips, anxious and agitated. 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 13:00.
Timeline: 1530 hours: Patient started feeling slightly short of breath, attributed it to exertion after climbing stairs. 1545 hours: Symptoms worsened rapidly, patient began using his salbutamol inhaler with minimal relief. 1550 hours: Patient's breathing became labored, chest tightness developed. 1555 hours: Patient called his son for help. 1600 hours: Son arrived and called emergency services. Current time, patient is sitting upright, struggling to breathe. Prior Events: Patient has had several COPD exacerbations in the past year, requiring hospitalization. Last exacerbation was 3 months ago. Last medical check-up was 1 month ago, routine follow-up. Patient lives alone, but his son lives nearby.
Initial Impression: Acute COPD Exacerbation with Respiratory Distress Justification for F2 Classification: - Patient experiencing significant respiratory distress with signs of hypoxia (cyanosis) - History of COPD with previous exacerbations - Time-sensitive condition requiring immediate intervention to prevent respiratory failure Differential Diagnoses: 1. Acute COPD Exacerbation (most likely) 2. Pneumonia (less likely, no reported fever or cough) 3. Pulmonary Embolism (less likely, no history of DVT) 4. Acute Heart Failure (less likely, no history of heart failure) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration - Continuous vital sign monitoring - Possible need for advanced airway management - Preparation for transport to nearest hospital with respiratory support