Hafnarstræti 18, 600 Akureyri, third floor apartment 3B. Five-story concrete residential building built in 1985. Main entrance requires intercom. One elevator and central stairwell. Street parking available. Building equipped with fire alarm system. Current conditions: 7°C, overcast, moderate visibility. GPS coordinates: 65.6837° N, 18.0921° W. Nearest landmark: Akureyri Art Museum.
78-year-old male, experiencing severe shortness of breath. Primary symptoms: Increased respiratory rate, use of accessory muscles, audible wheezing, cyanosis around lips. Patient reports worsening dyspnea over the last 24 hours. Secondary symptoms: Productive cough with yellowish sputum, chest tightness, feeling of anxiety. Patient is conscious but appears distressed. Medical history: COPD diagnosed 15 years ago, hypertension, type 2 diabetes. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (twice daily), Metformin 500mg twice daily, Lisinopril 10mg daily. Allergies: None known. Last meal was a light lunch at 13:00.
Timeline: 1400 hours: Patient reports mild shortness of breath and cough. 1600 hours: Shortness of breath worsens, patient uses salbutamol inhaler with minimal relief. 1800 hours: Patient develops chest tightness and audible wheezing. 1900 hours: Patient experiences significant increase in respiratory distress, becomes cyanotic. 1915 hours: Patient's son calls emergency services. 1917 hours: Current time, patient is sitting upright, struggling to breathe. Prior Events: Patient has had multiple COPD exacerbations in the past year, with one hospitalization 3 months ago. Patient has been compliant with his medications. No recent infections or illnesses. Last medical check-up 2 months ago, routine follow-up. Patient lives with his son.
Initial Impression: Severe COPD Exacerbation Justification for F2 Classification: - Significant respiratory distress with signs of hypoxia (cyanosis) - History of COPD exacerbations requiring prompt intervention - Time-sensitive condition requiring oxygen therapy and possible medication adjustment Differential Diagnoses: 1. COPD Exacerbation (high probability) 2. Pneumonia (possible, needs further evaluation) 3. Pulmonary Embolism (less likely given history and presentation) 4. Acute Heart Failure (less likely given known COPD) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy initiation - Bronchodilator administration - Preparation for transport to nearest hospital with respiratory services