Hafnarstræti 18, 600 Akureyri, third floor apartment 3B. A three-story brick building constructed in 1955. Main entrance is accessible via a coded door, code is 1234. No elevator available, only a central stairwell. Street parking available. The building is equipped with a basic fire alarm system. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6823° N, 18.0921° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Marked dyspnea at rest, audible wheezing, use of accessory muscles for breathing, cyanosis around lips. Patient reports feeling 'suffocated'. Secondary symptoms: Chest tightness, productive cough with small amount of yellow sputum. Patient is alert but anxious. Skin is clammy. Patient is sitting upright in a chair. Medical history: COPD diagnosed 5 years ago, type 2 diabetes, hypertension. Medications: Salbutamol inhaler as needed, Fluticasone/Salmeterol inhaler twice daily, Metformin 500mg twice daily, Lisinopril 10mg daily. Known allergy to penicillin. Last meal was a light lunch at 13:00.
Timeline: 1400 hours: Patient began experiencing mild shortness of breath 1415 hours: Symptoms worsened rapidly, wheezing started 1420 hours: Patient used his salbutamol inhaler, no relief 1425 hours: Patient's breathing became labored, chest tightness 1430 hours: Patient called his son for help 1435 hours: Son arrived, called emergency services 1438 hours: Current time, patient is still struggling to breathe Prior Events: Patient has had several exacerbations of COPD in the past year, requiring hospitalization twice. Last COPD-related hospital admission was 4 months ago. Patient reports having a mild cold last week, but no fever. Patient lives alone, but his son visits daily.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Patient presenting with severe respiratory distress, potential for rapid deterioration - Use of accessory muscles, wheezing, and cyanosis are indicative of significant respiratory compromise - Time-sensitive condition requiring prompt intervention to prevent respiratory failure Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pneumonia (possible, given recent cold symptoms) 3. Pulmonary Embolism (less likely, no sudden onset of chest pain) 4. Acute Heart Failure (less likely, no reported leg swelling or orthopnea) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy and bronchodilator administration - Monitoring of vital signs and respiratory status - Preparation for transport to nearest hospital with respiratory support