Hafnarstræti 18, 600 Akureyri, ground floor of a two-story wooden building constructed in 1950. Main entrance is on the street level, no steps. No elevator. Street parking available. Building has basic fire safety equipment. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6827° N, 18.0921° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe shortness of breath. Primary symptoms: Rapid, labored breathing, audible wheezing, cyanosis around the lips. Patient is conscious but agitated, struggling to speak in full sentences. Secondary symptoms: Chest tightness, anxiety, productive cough with small amount of white sputum. Patient is sitting upright in a chair, leaning forward. Medical history: Chronic obstructive pulmonary disease (COPD) diagnosed 5 years ago, hypertension, former smoker. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (twice daily), Lisinopril 10mg daily. Allergies: None known. Last meal was lunch at 13:00.
Timeline: 1530 hours: Patient started experiencing mild shortness of breath. 1545 hours: Shortness of breath worsened, with onset of wheezing. 1600 hours: Patient attempted to use his salbutamol inhaler, with minimal relief. 1610 hours: Patient's breathing became increasingly labored, cyanosis noted around lips. 1615 hours: Caller, patient's son, called emergency services. 1617 hours: Current time, patient is sitting up, struggling to breathe. Prior Events: Patient has had several exacerbations of COPD in the past, requiring hospital treatment. Last COPD exacerbation was 6 months ago. Patient reports he has not been feeling well for the past 2 days, with increased cough and sputum production. He has been using his inhalers more frequently than usual.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Significant respiratory distress with signs of hypoxemia (cyanosis) - Patient’s history of COPD and recent increase in symptoms - Time-sensitive condition requiring prompt intervention to prevent respiratory failure Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pulmonary Embolism (less likely, no sudden onset of severe chest pain) 3. Pneumonia (possible, given recent symptoms, but less likely as primary cause) 4. Acute Heart Failure (less likely, no history of heart failure) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy initiation - Bronchodilator administration - Preparation for transport to nearest hospital with respiratory services