Hafnarstræti 21, 600 Akureyri, ground floor of a two-story commercial building. Main entrance facing the street, glass doors, no security codes. Street parking available. Building is of modern construction, built in 2005. Current conditions: 7°C, overcast, light wind. GPS coordinates: 65.6822° N, 18.0918° W. Nearest landmark: Akureyri Art Museum.
62-year-old male, experiencing severe shortness of breath. Primary symptoms: Rapid and labored breathing, audible wheezing, chest tightness. Secondary symptoms: Cyanosis around lips, mild confusion. Patient is sitting upright, leaning forward. Medical history: Chronic obstructive pulmonary disease (COPD) diagnosed 5 years ago, hypertension, previous myocardial infarction 2 years ago. Medications: Salbutamol inhaler (2 puffs as needed), Tiotropium inhaler (1 puff daily), Amlodipine 10mg daily, Aspirin 75mg daily. Allergies: Penicillin. Last meal: Light lunch at 13:00.
Timeline: 1400 hours: Patient reports feeling slightly unwell, mild shortness of breath. 1415 hours: Shortness of breath worsened rapidly, onset of wheezing and chest tightness. 1420 hours: Patient became increasingly distressed, cyanosis around lips noticed by his colleague. 1422 hours: Colleague called emergency services. Patient is conscious but struggling to breathe. Prior Events: Patient had a COPD exacerbation 6 months ago, treated with oral steroids and antibiotics. No recent infections. Has been compliant with medication regimen. Smokes 1 pack of cigarettes per day.
Initial Impression: Acute Exacerbation of COPD with Respiratory Distress Justification for F2 Classification: - High probability of severe respiratory compromise requiring prompt intervention - Patient exhibiting significant symptoms (dyspnea, wheezing, cyanosis) - History of COPD and recent MI increases risk of deterioration - Time-sensitive condition requiring immediate respiratory support and monitoring Differential Diagnoses: 1. Acute Exacerbation of COPD (most likely) 2. Pulmonary Embolism (less likely, no sudden chest pain) 3. Acute Myocardial Infarction (less likely, no crushing chest pain) 4. Pneumonia (possible, but less likely given rapid onset) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration and monitoring - Bronchodilator administration - Preparation for transport to nearest hospital with respiratory care facilities