Hafnarstræti 23, 600 Akureyri, third floor apartment 3B. A three-story wooden building constructed in 1955. Main entrance requires key or intercom. No elevator, only a central stairwell. Street parking available. Building has smoke detectors. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6812° N, 18.0910° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Rapid and labored breathing, use of accessory muscles, audible wheezing. Patient reports feeling lightheaded and anxious. Secondary symptoms: Productive cough with yellow sputum, mild chest pain. Patient is sitting upright, appears pale and diaphoretic. Medical history: COPD diagnosed 5 years ago, history of smoking, hypertension. Medications: Salbutamol inhaler as needed, Fluticasone inhaler twice daily, Lisinopril 10mg daily. Known allergy to Penicillin. Last meal was a light lunch at 13:00.
Timeline: 1400 hours: Patient started experiencing increased shortness of breath 1415 hours: Symptoms worsened, patient began using salbutamol inhaler without relief 1420 hours: Patient developed chest pain and productive cough 1425 hours: Patient called his son for help 1430 hours: Son arrived and called emergency services 1432 hours: Current time, patient is still experiencing severe respiratory distress Prior Events: Patient has had several exacerbations of COPD in the past year, including one hospitalization 6 months ago. Last pulmonary function test 9 months ago showed moderate to severe COPD. No recent fever or illness. Patient has been a smoker for 40 years, but has reduced smoking in the last 2 years.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Significant respiratory distress with potential for rapid deterioration - Patient is symptomatic despite use of rescue inhaler - Requires prompt medical evaluation, oxygen administration, and potential respiratory support Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pneumonia (less likely given no fever) 3. Pulmonary Embolism (less likely given no sudden onset of symptoms) 4. Acute Heart Failure (less likely given absence of significant edema) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration - Continuous monitoring of vital signs - Preparation for transport to nearest hospital with respiratory services