Hafnarstræti 19, 600 Akureyri, second floor, apartment 202. A three-story mixed-use building with commercial spaces on the ground floor and apartments above, built in 1965. Main entrance on Hafnarstræti with a buzzer system for apartment access. No elevator; access via a central staircase. Street parking is available along Hafnarstræti. Building is equipped with a basic fire alarm system. Current weather: 7°C, overcast, light wind. GPS coordinates: 65.6828° N, 18.0899° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Rapid and labored breathing, audible wheezing, chest tightness. Secondary symptoms: Increased heart rate, pale and sweaty skin, patient is anxious and struggling to speak in full sentences. Patient is sitting upright on a chair. Medical history: Chronic obstructive pulmonary disease (COPD), history of mild heart failure, hypertension. Medications: Salbutamol inhaler (as needed), Tiotropium inhaler (daily), Lisinopril 10mg daily, Metoprolol 25mg daily. Known allergy to penicillin. Last meal was a small lunch at 13:00.
Timeline: 1415 hours: Patient started experiencing increased shortness of breath while resting 1420 hours: Symptoms worsened with noticeable wheezing and chest tightness 1425 hours: Patient attempted to use his salbutamol inhaler, with no relief 1428 hours: Patient called his son for help 1430 hours: Son arrived, called emergency services 1432 hours: Current time, patient is still struggling to breathe, son is assisting him to remain upright Prior Events: Patient reports a recent upper respiratory infection 3 weeks ago. He has been using his inhalers more frequently than usual for the past week. He has been compliant with his medications. Last medical check-up 6 months ago, routine follow-up. Patient lives alone, son lives nearby.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Significant respiratory distress with labored breathing and wheezing - Patient's history of COPD and heart failure increases risk - Time-sensitive condition requiring prompt intervention to prevent respiratory failure Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Acute Heart Failure (possible, given history) 3. Pneumonia (less likely, no fever reported) 4. Pulmonary Embolism (less likely, no sudden onset of sharp pain) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy initiation - Bronchodilator administration - Monitoring of vital signs and level of consciousness - Preparation for transport to nearest hospital with respiratory support