Hafnarstræti 18, 600 Akureyri, Ground floor of a two-story commercial building, built in 1965. Main entrance facing Hafnarstræti, with a secondary service entrance at the rear. No elevator. Street parking available. Building has basic fire safety equipment. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6822° N, 18.0915° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Marked dyspnea, wheezing, productive cough with yellow sputum, cyanosis around lips. Secondary symptoms: Increased heart rate, diaphoresis, anxiety. Patient is conscious but agitated. Patient sitting upright in a chair in the office. Medical history: Chronic Obstructive Pulmonary Disease (COPD) diagnosed 5 years ago, hypertension, type 2 diabetes. Medications: Salmeterol/Fluticasone inhaler 250/50 mcg twice daily, Metformin 500mg twice daily, Lisinopril 10mg daily. Allergies: Penicillin. Last meal was a sandwich at 12:00.
Timeline: 1315 hours: Patient began experiencing mild shortness of breath. 1330 hours: Symptoms progressively worsened, developed a productive cough. 1340 hours: Patient started wheezing, became increasingly anxious. 1345 hours: Patient called his son for help. 1350 hours: Son arrived, called emergency services. Patient now with significant respiratory distress. Prior Events: Patient had a mild cold 2 weeks ago. No recent changes in medications. Has been compliant with inhaler use. Last medical check-up was 6 months ago, routine follow-up. Patient is a smoker (1 pack/day for 40 years).
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Moderate to severe respiratory distress with clear signs of exacerbation - Patient is symptomatic, cyanotic, and has altered breathing pattern - Time-sensitive condition requiring prompt medical intervention to prevent further deterioration Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pneumonia (possible, given productive cough) 3. Pulmonary Embolism (less likely, no chest pain reported) 4. Acute Heart Failure (less likely, no history of heart failure) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration protocol initiation - Bronchodilator administration - Preparation for transport to nearest hospital with respiratory services