Hafnarstræti 18, 600 Akureyri, ground floor of a two-story wooden building. Main entrance at street level, no steps. Building constructed in 1948, previously a retail space, now a small office. Parking available on the street. No security features, public access. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6832° N, 18.0914° W. Nearest landmark: Akureyri Art Museum.
58-year-old male, experiencing severe shortness of breath. Primary symptoms: Rapid, labored breathing, wheezing, inability to speak in full sentences. Secondary symptoms: Chest tightness, pale and sweaty skin, anxiety. Patient is conscious but agitated. Medical history: Chronic obstructive pulmonary disease (COPD) diagnosed 5 years ago, history of smoking. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (twice daily), Theophylline 200mg daily. No known allergies. Last meal was a light lunch at 13:00.
Timeline: 1430 hours: Patient began experiencing mild shortness of breath 1445 hours: Shortness of breath worsened, patient used his Salbutamol inhaler with no relief 1500 hours: Patient reports severe difficulty breathing, chest tightness 1505 hours: Patient called his son for help 1510 hours: Son arrived, called emergency services 1512 hours: Current time, patient is still experiencing severe respiratory distress Prior Events: Patient had a mild COPD exacerbation 2 weeks ago, managed at home with increased inhaler use. No recent hospitalizations. Smokes approximately 1 pack of cigarettes per day. Last medical check-up 6 months ago, routine follow-up.
Initial Impression: Acute COPD Exacerbation Justification for F2 Classification: - High probability of significant respiratory compromise based on history and presentation - Patient experiencing severe shortness of breath, requiring urgent medical intervention - Potential for rapid deterioration if not treated promptly Differential Diagnoses: 1. COPD Exacerbation (high probability) 2. Acute Asthma Exacerbation (less likely given history) 3. Pulmonary Embolism (lower probability, no chest pain or leg swelling) 4. Pneumonia (possible, but no reported fever or cough) 5. Acute Heart Failure (less likely given no prior history) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration - Bronchodilator treatment - Continuous monitoring of respiratory status - Preparation for transport to nearest hospital with respiratory services