Hafnarstræti 18, 600 Akureyri. Third floor, apartment 3B. Four-story building, concrete construction, built in 1965, with a single main entrance facing Hafnarstræti. Elevator and central stairwell available. No specific security features, street parking. Current weather: 7°C, overcast, light wind. GPS: 65.6821° N, 18.0912° W. Landmark: Akureyri Art Museum.
62-year-old male, sudden onset of severe shortness of breath. Primary symptoms: Significant difficulty breathing, wheezing, chest tightness. Secondary symptoms: Mild cyanosis around lips, productive cough with clear sputum, appears anxious and agitated. Patient is sitting upright on the edge of his bed. Medical history: Asthma diagnosed in childhood, COPD diagnosed 5 years ago, hypertension. Medications: Salbutamol inhaler (as needed), Beclomethasone inhaler (2 puffs twice daily), Lisinopril 10mg daily. Known allergy to pollen. Last meal was a light lunch at 13:00.
Timeline: 14:30 hours: Patient started feeling mild shortness of breath while watching TV 14:45 hours: Shortness of breath worsened, patient used salbutamol inhaler without relief 14:50 hours: Patient developed chest tightness and increased difficulty breathing, started coughing 14:55 hours: Patient called his son for help, son called emergency services 14:58 hours: Current time, patient is still struggling to breathe, sitting upright on bed Prior Events: Patient reports a mild cold last week, no recent hospitalizations. Has had several asthma exacerbations in the past year, managed with inhalers and oral steroids. Last pulmonary function test was 6 months ago, showed moderate COPD. No recent changes in medications. Patient is a smoker, approximately 1 pack per day for 40 years.
Initial Impression: Acute Asthma/COPD Exacerbation Justification for F2 Classification: - Moderate to severe respiratory distress with cyanosis and wheezing - Patient has history of asthma and COPD, increasing risk of rapid deterioration - Time-sensitive condition requiring immediate medical intervention Differential Diagnoses: 1. Acute Asthma Exacerbation (high probability) 2. Acute COPD Exacerbation (high probability) 3. Pulmonary Embolism (less likely given history) 4. Acute Heart Failure (less likely given primary respiratory symptoms) 5. Pneumonia (possible, but less likely without fever) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration and respiratory support protocols - Medication administration (bronchodilators, steroids) - Preparation for transport to nearest hospital with respiratory services