Hafnarstræti 23, 600 Akureyri, ground floor of a two-story wooden building. Built in 1950. Main entrance is street-level with a small step. No elevator. Stairwell is narrow. Street parking available. No security features. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6810° N, 18.0912° W. Nearest landmark: Akureyri Art Museum.
78-year-old male, experiencing severe shortness of breath. Primary symptoms: Rapid and labored breathing, audible wheezing, use of accessory muscles, cyanosis around lips. Secondary symptoms: Increased heart rate, agitation, productive cough with yellow sputum. Patient is conscious but struggling to speak in full sentences. Patient sitting upright in a chair. Medical history: COPD diagnosed 5 years ago, type 2 diabetes. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (2 puffs twice daily), Metformin 1000mg twice daily, Atorvastatin 20mg daily. Allergies: None known. Last meal was a light lunch at 13:00.
Timeline: 1430 hours: Patient started experiencing increased shortness of breath 1445 hours: Patient used Salbutamol inhaler with no relief 1450 hours: Patient's breathing worsened, developed audible wheezing 1455 hours: Patient became agitated and started coughing up yellow sputum 1500 hours: Caller (patient's son) arrived and called emergency services 1505 hours: Current time, patient's condition remains severe Prior Events: Patient has had several COPD exacerbations in the past year, with one hospitalization 6 months ago. Recent upper respiratory infection 2 weeks ago, but resolved. No recent changes to medication regimen. Patient lives alone, but son checks on him daily.
Initial Impression: Severe COPD Exacerbation Justification for F2 Classification: - Respiratory distress with significant symptoms (wheezing, cyanosis, accessory muscle use) - Patient has a history of COPD and recent exacerbations - Time-sensitive condition requiring prompt medical intervention Differential Diagnoses: 1. COPD Exacerbation (high probability) 2. Pneumonia (possible, given productive cough) 3. Pulmonary Embolism (less likely, no reported chest pain) 4. Acute Heart Failure (less likely, no reported leg swelling or orthopnea) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration - Bronchodilator administration - IV access and fluid administration if needed - Preparation for transport to nearest hospital with respiratory support