Hafnarstræti 18, 600 Akureyri. Third-floor apartment in a four-story concrete building built in 1965. Access via a main entrance with an intercom system and a back entrance with a code lock (code 1972). One elevator and a central stairwell. Street parking is available, but can be limited during peak hours. The building is equipped with a fire alarm system. Current conditions: 8°C, overcast, moderate wind. GPS coordinates: 65.6823° N, 18.0915° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Rapid and labored breathing, chest tightness, cyanosis around lips. Secondary symptoms: Agitation, confusion, productive cough with white sputum. Patient reports sudden onset of symptoms about 30 minutes ago. Patient is sitting upright in a chair, appears distressed. Medical history: Chronic obstructive pulmonary disease (COPD) diagnosed 5 years ago, history of smoking. Medications: Salbutamol inhaler (as needed), Tiotropium inhaler daily, Prednisone 5mg daily. Known allergy to penicillin. Last meal was a light lunch at 13:00.
Timeline: 14:15 hours: Patient began experiencing mild shortness of breath. 14:30 hours: Symptoms worsened rapidly, with increased breathing difficulty and chest tightness. 14:35 hours: Patient started coughing with white sputum and became agitated. 14:40 hours: Patient called his son for help. Son arrived and called emergency services. 14:45 hours: Current time, patient is sitting upright, struggling to breathe. Prior Events: Patient reports a recent upper respiratory infection a week ago, which had seemed to resolve. No recent hospitalizations. Patient has been using his inhalers as prescribed but reports they are not providing relief. Last medical check-up 2 months ago, routine follow-up.
Initial Impression: Acute Exacerbation of COPD with Respiratory Distress Justification for F2 Classification: - High probability of significant respiratory compromise based on presentation - Patient exhibits severe shortness of breath, cyanosis, and agitation - Time-sensitive condition requiring immediate respiratory support Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pulmonary Embolism (possible, needs to be ruled out) 3. Pneumonia (possible, recent infection history) 4. Acute Heart Failure (less likely, no prior history) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration and respiratory support - Monitoring of vital signs and level of consciousness - Preparation for transport to nearest hospital with respiratory services