Hafnarstræti 23, 600 Akureyri. Ground floor of a two-story wooden building constructed in 1950. Main entrance is street-level, no steps. No elevator. Parking available on street. Building has no specific security features. Current conditions: 8°C, clear skies, good visibility. GPS coordinates: 65.6812° N, 18.0911° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe shortness of breath. Primary symptoms: severe dyspnea, wheezing, use of accessory muscles, cyanosis around lips. Secondary symptoms: chest tightness, anxiety, diaphoresis. Patient is conscious but struggling to breathe. Patient sitting upright on a chair in his living room. Medical history: COPD diagnosed 5 years ago, hypertension, type 2 diabetes. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (twice daily), Metformin 500mg twice daily, Lisinopril 10mg daily. Known allergy to penicillin. Last meal was a small lunch at 13:00.
Timeline: 1400 hours: Patient started experiencing increased shortness of breath, initially mild 1415 hours: Shortness of breath worsened, started using salbutamol inhaler, no relief 1430 hours: Patient became increasingly distressed, wheezing and chest tightness developed 1440 hours: Current time, patient is struggling to breathe, called emergency services Prior Events: Patient reports several exacerbations of COPD in the past year, requiring hospitalization once. Last medical check-up 2 months ago, routine follow-up. Patient lives alone. No recent infections or injuries reported.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Significant respiratory distress with use of accessory muscles and cyanosis - History of COPD with previous exacerbations - Time-sensitive condition requiring prompt medical intervention to prevent respiratory failure Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pulmonary Embolism (less likely given no recent immobilization or surgery) 3. Pneumonia (possible, but less likely given no fever or productive cough) 4. Acute Heart Failure (possible, but less likely given primary respiratory symptoms) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy initiation - Bronchodilator administration - Continuous monitoring of vital signs - Preparation for transport to nearest hospital with respiratory services