Hafnarstræti 77, 600 Akureyri. Ground floor of a two-story commercial building, constructed in 1965. Main entrance faces the street. No elevator, interior access via single door. Street parking available. Building equipped with basic fire alarm system. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6838° N, 18.0916° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Labored breathing, rapid respiratory rate, wheezing, and cyanosis around the lips. Secondary symptoms: Chest tightness, dizziness, and anxiety. Patient is conscious but agitated. Medical history: COPD diagnosed 5 years ago, hypertension, and type 2 diabetes. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (twice daily), Metformin 500mg (twice daily), Lisinopril 10mg (daily). Known allergy to penicillin. Last meal was a small lunch at 13:00.
Timeline: 1400 hours: Patient began feeling short of breath, initially mild 1415 hours: Symptoms worsened rapidly, developed wheezing and chest tightness 1420 hours: Patient used his Salbutamol inhaler, with minimal relief 1425 hours: Patient became increasingly distressed, developed cyanosis 1430 hours: Caller (patient's son) arrived and called emergency services 1432 hours: Current time, patient is struggling to breathe, conscious but agitated Prior Events: Patient reports a recent upper respiratory infection 3 days ago. No recent hospitalizations. Last medical check-up was 2 months ago, routine follow-up for COPD.
Initial Impression: Acute Exacerbation of COPD with Respiratory Distress Justification for F2 Classification: - Severe respiratory distress with rapid onset of symptoms - Presence of cyanosis indicates significant hypoxia - Patient has a history of COPD, increasing risk of rapid deterioration - Time-sensitive condition requiring immediate intervention to prevent respiratory failure Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pulmonary Embolism (less likely given the history and presentation) 3. Pneumonia (possible, but less likely given rapid onset) 4. Acute Heart Failure (less likely, no history of cardiac issues) Required Actions: - Dispatch of ground EMS with ALS capabilities - High-flow oxygen administration - Bronchodilator therapy (nebulized if available) - Monitoring of vital signs and level of consciousness - Preparation for possible intubation and mechanical ventilation