Hafnarstræti 18, 600 Akureyri, ground floor of a two-story commercial building. Built in 1955, concrete and wood construction. Main entrance on the street, no security features. Street parking available. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6828° N, 18.0916° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Labored breathing, wheezing, cyanosis around the lips. Patient reports sudden onset of breathing difficulty. Secondary symptoms: Chest tightness, anxiety. Patient is conscious but distressed. Patient is sitting upright in a chair. Medical history: COPD diagnosed 5 years ago, history of smoking, hypertension. Medications: Salbutamol inhaler (as needed), Fluticasone inhaler (daily), Lisinopril 10mg daily. No known allergies. Last meal was a light lunch at 12:00.
Timeline: 1330 hours: Patient started feeling mild shortness of breath while walking 1345 hours: Symptoms worsened rapidly, patient became severely short of breath, and developed wheezing 1350 hours: Patient used his salbutamol inhaler, with no improvement 1352 hours: Patient called his son for help 1355 hours: Son arrived, called emergency services 1357 hours: Current time, patient still experiencing severe shortness of breath Prior Events: Patient reports recent upper respiratory infection in the past week. Patient usually uses his inhalers daily. No recent hospitalizations.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Severe respiratory distress, cyanosis, and lack of improvement with bronchodilator - Potential for rapid deterioration requiring immediate medical intervention - Time-sensitive condition requiring prompt oxygen therapy and possible intubation Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pulmonary Embolism (less likely, no recent surgery or immobilization) 3. Acute Heart Failure (less likely, no prior history of heart failure) 4. Pneumonia (possible, but less likely given sudden onset of symptoms) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy initiation - Monitoring of vital signs - Preparation for transport to nearest hospital with respiratory support