Hafnarstræti 22, 600 Akureyri, first floor, apartment 102. A three-story brick building constructed in 1965. Main entrance accessible via street level with a small step. Building has a fire alarm system. Street parking is available, but may be limited during peak hours. Current conditions: 7°C, overcast, light wind. GPS coordinates: 65.6823° N, 18.0895° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe shortness of breath. Primary symptoms: Marked difficulty breathing, rapid and shallow respirations, audible wheezing, using accessory muscles. Secondary symptoms: Cyanosis around lips, increased anxiety, patient reports chest tightness. Patient is sitting upright on the edge of his bed. Medical history: Chronic obstructive pulmonary disease (COPD) diagnosed 5 years ago, hypertension. Medications: Salbutamol inhaler (2 puffs as needed), Fluticasone/Salmeterol inhaler (1 puff twice daily), Lisinopril 10mg daily. Known allergy: Sulfa drugs. Last meal was a light lunch at 13:00.
Timeline: 1400 hours: Patient started feeling slightly short of breath 1415 hours: Shortness of breath worsened, patient used his Salbutamol inhaler with no relief 1420 hours: Patient began experiencing chest tightness and increased respiratory distress 1425 hours: Patient called his son for help 1430 hours: Son arrived and called emergency services 1432 hours: Current time, patient is sitting up, struggling to breathe Prior Events: Patient reports a recent upper respiratory infection 1 week ago, treated with over-the-counter medication. Patient has been compliant with his prescribed medications. No recent hospitalizations or emergency department visits. Patient is a former smoker, quit 10 years ago.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Severe respiratory distress with signs of hypoxia (cyanosis) - Patient has a known history of COPD, making this an acute exacerbation - Time-sensitive condition requiring prompt oxygen therapy and bronchodilator administration Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pulmonary Embolism (less likely, no reported chest pain) 3. Acute Heart Failure (less likely, no reported edema or prior history) 4. Pneumothorax (less likely, no reported sudden onset of unilateral chest pain) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy initiation - Bronchodilator administration via nebulizer if available - Preparation for transport to nearest hospital with respiratory services