Hafnarstræti 78, 600 Akureyri, first floor, apartment 103. A three-story mixed-use building with commercial spaces on the ground floor and residential units above. Built in 1965, concrete structure. Main entrance has a coded lock, code is 1973. One elevator and one main stairwell. Street parking available. Building is equipped with a basic fire alarm system. Current weather: 8°C, overcast, light wind. GPS coordinates: 65.6837° N, 18.0915° W. Nearest landmark: Akureyri Art Museum.
70-year-old male, experiencing severe shortness of breath. Primary symptoms: Significant difficulty breathing, audible wheezing, productive cough with yellow sputum. Secondary symptoms: Chest tightness, mild cyanosis around lips, patient is anxious and agitated. Patient is sitting upright in a chair, struggling to breathe. Medical history: COPD diagnosed 5 years ago, history of smoking, hypertension, and type 2 diabetes. Medications: Salbutamol inhaler (as needed), Tiotropium inhaler (daily), Metformin 500mg twice daily, Lisinopril 10mg daily. Allergies: None known. Last meal: light lunch at 13:00.
Timeline: 1400 hours: Patient started experiencing increased shortness of breath. 1415 hours: Patient used his Salbutamol inhaler, with minimal relief. 1420 hours: Symptoms worsened, with increased wheezing and productive cough. 1425 hours: Patient called his son for help. 1430 hours: Son arrived and called emergency services. 1432 hours: Current time, patient is in severe respiratory distress. Prior Events: Patient reports a recent cold two weeks ago, has been using his inhalers more frequently than usual for the past few days. No recent hospitalizations. Last medical check-up was 6 months ago.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Significant respiratory distress with wheezing and cyanosis indicates potential for rapid deterioration. - Patient has a known history of COPD and is presenting with an acute exacerbation. - Time-sensitive condition requiring prompt medical intervention to prevent respiratory failure. Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pneumonia (consider based on productive cough) 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 administration and monitoring. - Bronchodilator treatment initiation. - Preparation for potential advanced airway management.