Hafnarstræti 18, 600 Akureyri, third floor apartment 3B. A three-story, older wooden building constructed in 1945. Main entrance has a coded lock (code 2749). No elevator, access via a narrow stairwell. Street parking available but can be limited. Building has a basic fire alarm system. Current conditions: 7°C, overcast, moderate wind. GPS coordinates: 65.6831° N, 18.0923° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Labored breathing, wheezing, chest tightness, unable to speak in full sentences. Secondary symptoms: Cyanosis around lips, rapid heart rate. Patient is conscious but agitated. Medical history: COPD diagnosed 5 years ago, history of smoking, hypertension. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (twice daily), Lisinopril 10mg daily. Allergies: None known. Last meal was a light lunch at 13:00.
Timeline: 1430 hours: Patient started feeling slightly short of breath 1445 hours: Symptoms rapidly worsened, severe shortness of breath, wheezing 1450 hours: Patient unable to walk without significant distress 1455 hours: Patient’s son called emergency services 1457 hours: Current time, patient sitting upright, struggling to breathe Prior Events: Patient reports several exacerbations of COPD in the past year, last hospitalization for COPD was 6 months ago. Patient has not been compliant with smoking cessation recommendations. No recent illnesses reported. Last medical check-up was 2 months ago, routine follow-up.
Initial Impression: Acute COPD Exacerbation Justification for F2 Classification: - Significant respiratory distress with labored breathing and cyanosis - Patient has known COPD, increasing likelihood of severe exacerbation - Time-sensitive condition requiring prompt intervention to prevent respiratory failure Differential Diagnoses: 1. Acute COPD Exacerbation (high probability) 2. Pulmonary Embolism (less likely given gradual onset) 3. Acute Heart Failure (less likely given history of COPD) 4. Pneumonia (possible but less likely given lack of fever) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration and airway support - Bronchodilator administration - Preparation for transport to nearest hospital with respiratory support