Hafnarstræti 18, 600 Akureyri, third floor, apartment 3B. A four-story concrete building, built in 1985. The main entrance has a buzzer system and requires a code for access. There is an elevator and a central stairwell. Street parking is available. The building has a basic fire alarm system. Current weather conditions: 8°C, overcast, light wind. GPS coordinates: 65.6822° N, 18.0921° W. The nearest landmark is the Cultural Centre Hof.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Rapid, labored breathing, audible wheezing, chest tightness. Secondary symptoms: Mild cyanosis around lips, anxiety. Patient is conscious but struggling to speak in full sentences. Patient is sitting upright in a chair in the living room. Medical history: COPD diagnosed 5 years ago, previous hospitalization for exacerbation 2 years ago, mild hypertension. Medications: Salbutamol inhaler (2 puffs as needed), Fluticasone/Salmeterol inhaler (1 puff twice daily), Lisinopril 10mg daily. Known allergy: Penicillin. Last meal was a light lunch at 12:00. Patient reports that he has had a cold for the past few days.
Timeline: 1400 hours: Patient felt mild shortness of breath after walking upstairs 1415 hours: Shortness of breath worsened, patient used Salbutamol inhaler with minimal relief 1430 hours: Patient called his son for help, condition continued to worsen 1440 hours: Son arrived, called emergency services 1442 hours: Current time, patient is struggling to breathe, sitting upright, pale and anxious Prior Events: Patient has experienced several COPD exacerbations in the past, but none this severe in the last year. He reports increased sputum production and a mild cough over the last 3 days. He has been compliant with his medications.
Initial Impression: Acute Exacerbation of COPD with Respiratory Distress Justification for F2 Classification: - Patient is experiencing severe respiratory distress, indicating a potential life-threatening situation - Symptoms include rapid breathing, wheezing, and cyanosis, suggesting significant respiratory compromise - Time-sensitive condition requiring prompt medical intervention and oxygen therapy Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pneumonia (possible, given recent cold symptoms) 3. Pulmonary Embolism (less likely given history, but must be considered) 4. Acute Heart Failure (less likely given known COPD history, but must be considered) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy initiation - Bronchodilator administration - Preparation for transport to nearest hospital with respiratory support