Hafnarstræti 21, 600 Akureyri, ground floor of a two-story wooden building built in 1955. Main entrance is on the street level, no stairs. No elevator. Street parking available. Building has a basic security system with a simple lock. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6821° N, 18.0897° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Difficulty breathing, wheezing, productive cough with yellowish sputum. Secondary symptoms: Chest tightness, feeling anxious and restless, pale skin. Patient is sitting upright, struggling to speak in full sentences. Medical history: COPD diagnosed 5 years ago, hypertension, type 2 diabetes. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (2 puffs twice daily), Metformin 500mg twice daily, Lisinopril 10mg daily. Known allergy to penicillin. Last meal was lunch at 13:00.
Timeline: 1500 hours: Patient started feeling unwell with mild cough 1530 hours: Cough worsened, started having difficulty breathing 1545 hours: Patient used his salbutamol inhaler with no improvement 1600 hours: Patient’s breathing became more labored, developed chest tightness 1605 hours: Patient called emergency services 1607 hours: Current time, patient is still struggling to breathe Prior Events: Patient reports a similar episode 6 months ago requiring hospital admission. Patient has been experiencing increased sputum production over the last 3 days. No recent travel or known exposure to respiratory infections. Patient is a retired fisherman and lives with his wife.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Respiratory distress with wheezing and productive cough - History of COPD with recent symptom worsening - Failure to respond to initial bronchodilator - Potential for rapid deterioration Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pneumonia (consider if fever present) 3. Pulmonary Embolism (less likely given presentation) 4. Acute Heart Failure (consider if new onset edema) 5. Allergic Reaction (less likely given lack of typical symptoms) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration - Continuous monitoring of respiratory status - Preparation for potential need for advanced airway management