Hafnarstræti 18, 600 Akureyri, ground floor of the old fish factory, now a mixed-use building. Three-story brick building constructed in 1930. Main entrance faces the harbor. No elevator, only a single stairwell. Street parking available. Building has basic security with a standard lock. Current conditions: 7°C, cloudy, good visibility. GPS coordinates: 65.6833° N, 18.0922° W. Nearest landmark: Akureyri harbor.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Rapid and labored breathing, wheezing, cyanosis around lips. Patient is conscious but appears anxious and struggling to breathe. Secondary symptoms: Chest tightness, productive cough with small amount of clear sputum. Patient is sitting upright in a chair. Medical history: COPD diagnosed 5 years ago, previous history of pneumonia. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (twice daily), Theophylline 200mg daily. Known allergy to penicillin. Last meal was a light lunch at 13:00.
Timeline: 1400 hours: Patient started experiencing mild shortness of breath. 1415 hours: Shortness of breath worsened rapidly, accompanied by wheezing. 1420 hours: Patient used his Salbutamol inhaler, with minimal relief. 1425 hours: Symptoms continue to worsen; patient's son called emergency services. 1430 hours: Current time, patient is struggling to breathe, appears cyanotic. Prior Events: Patient has had multiple COPD exacerbations in the past year, requiring hospitalizations. Last COPD exacerbation was 3 months ago. Patient reports a recent cold in the past week. Last medical check-up 2 weeks ago, routine follow-up.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - High risk of respiratory failure due to acute exacerbation of COPD - Patient is showing signs of respiratory distress (cyanosis, labored breathing) - Time-sensitive condition requiring immediate medical intervention Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pneumonia (possible given recent cold) 3. Pulmonary Embolism (less likely given history and presentation) 4. Acute Heart Failure (less likely, no reported chest pain) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy administration - Bronchodilator administration - Preparation for transport to nearest hospital with respiratory support