Hafnarstræti 18, 600 Akureyri, third floor apartment 3B. A four-story reinforced concrete building built in 1965. Main entrance has a key code and intercom system. One elevator and central stairwell. Street parking available. The building has a fire alarm system. Current weather: 7°C, overcast, light wind. GPS coordinates: 65.6825° N, 18.0900° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe shortness of breath. Primary symptoms: Significant dyspnea at rest, wheezing, productive cough with yellow sputum, cyanosis around lips. Secondary symptoms: Chest tightness, anxiety, diaphoresis. Patient is conscious but agitated. Patient is sitting upright on the edge of his bed. Medical history: Chronic Obstructive Pulmonary Disease (COPD), diagnosed 15 years ago, type 2 diabetes. Medications: Salbutamol inhaler (2 puffs PRN), Formoterol inhaler (2 puffs twice daily), Metformin 500mg twice daily, Atorvastatin 20mg daily. Allergies: Penicillin. Last meal was a small bowl of soup at 18:00.
Timeline: 2000 hours: Patient started feeling unwell with a mild cough. 2100 hours: Cough worsened, with increased sputum production. 2130 hours: Patient started experiencing shortness of breath and chest tightness. 2145 hours: Patient used his salbutamol inhaler with no relief. 2150 hours: Patient’s breathing became labored, and he started feeling very anxious. 2155 hours: Caller (patient’s son) arrived at the apartment and called emergency services. 2200 hours: Current time, patient is sitting up, struggling to breathe. Prior Events: Patient has had several exacerbations of COPD in the past year, requiring hospital admission. Last hospital admission was 6 months ago for a similar episode. Patient reports no recent exposure to respiratory infections.
Initial Impression: Acute Exacerbation of COPD with Respiratory Distress Justification for F2 Classification: - Significant respiratory distress with shortness of breath at rest, wheezing, and cyanosis. - Patient has known history of COPD and is experiencing a severe exacerbation. - Time-sensitive condition requiring prompt medical intervention, including oxygen administration and possible airway support. Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pneumonia (less likely without fever, but possible) 3. Pulmonary Embolism (less likely given history, but needs consideration) 4. Acute Heart Failure (less likely given no known history of heart disease) Required Actions: - Dispatch of ground EMS with ALS capabilities. - Oxygen administration and assessment of respiratory status. - Preparation for potential advanced airway management. - Immediate transport to nearest hospital with respiratory support capabilities.