Hafnarstræti 18, 600 Akureyri, ground floor of a two-story commercial building. The building is of mixed construction, with a concrete base and wooden upper floor, built in 1965. Main entrance is at street level with a single door. No elevator. Street parking available. No security features beyond standard door lock. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6822° N, 18.0899° W. Nearest landmark: Akureyri Art Museum.
47-year-old male, experiencing severe shortness of breath. Primary symptoms: Severe dyspnea, wheezing, productive cough with yellow sputum, use of accessory muscles for breathing, chest tightness. Secondary symptoms: Agitation, diaphoresis, tachycardia. Patient is conscious but struggling to speak in full sentences. Patient is at his workplace, a small office. Medical history: Asthma diagnosed in childhood, seasonal allergies. Medications: Salbutamol inhaler (Ventolin) 100mcg, Fluticasone inhaler (Flovent) 250mcg, both as needed, last used 6 hours ago. Known allergy to pollen. Last meal was a sandwich at 12:00. No recent infections.
Timeline: 1300 hours: Patient reports feeling slightly unwell, with mild wheezing. 1330 hours: Symptoms worsen, with increased shortness of breath and chest tightness. 1400 hours: Patient uses Salbutamol inhaler, no relief. 1410 hours: Symptoms rapidly escalate, with severe dyspnea and productive cough. 1415 hours: Patient calls emergency services, current time. Prior Events: Patient reports frequent asthma exacerbations in spring and summer. No recent hospitalizations. Last medical check-up 6 months ago, routine follow-up. Patient reports possible exposure to dust at work earlier today.
Initial Impression: Acute Asthma Exacerbation Justification for F2 Classification: - Significant respiratory distress with severe dyspnea, wheezing, and use of accessory muscles - Failure to respond to initial bronchodilator therapy - Potential for rapid deterioration and respiratory failure Differential Diagnoses: 1. Acute Asthma Exacerbation (high probability) 2. Pneumonia (less likely given lack of fever and acute onset) 3. Anaphylaxis (less likely, no known allergen exposure at time of onset) 4. Pulmonary Embolism (less likely, no risk factors) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration and ventilatory support - Administration of bronchodilators and corticosteroids - Preparation for transport to nearest hospital with respiratory support capabilities