Hafnarstræti 18, 600 Akureyri, third floor apartment 3B. Five-story concrete residential building constructed in 1985. Main entrance requires key or intercom. One elevator and central stairwell. Street parking available. Building equipped with fire alarm system. Current conditions: 7°C, overcast, moderate visibility. GPS coordinates: 65.6811° N, 18.0914° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Severe dyspnea, rapid and shallow breathing, productive cough with yellow sputum, chest tightness. Secondary symptoms: Mild cyanosis around lips, audible wheezing. Patient is conscious but appears anxious and distressed. Patient is sitting upright in a chair. Medical history: COPD diagnosed 5 years ago, history of smoking, hypertension. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (2 puffs twice daily), Lisinopril 10mg daily. Allergies: None known. Last meal was a light lunch at 12:00.
Timeline: 1300 hours: Patient started experiencing mild shortness of breath, attributed to usual COPD 1330 hours: Shortness of breath worsened, started using Salbutamol inhaler with minimal relief 1345 hours: Patient began coughing up yellow sputum, chest tightness increased 1350 hours: Current time, patient in severe respiratory distress, called emergency services Prior Events: Patient reports a recent upper respiratory infection 3 weeks ago. No recent hospitalizations. Last medical check-up 6 months ago, routine follow-up. Patient lives alone.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Significant respiratory distress with cyanosis and audible wheezing - Potential for rapid deterioration requiring prompt medical intervention - Patient's history of COPD and recent infection increases risk of severe exacerbation Differential Diagnoses: 1. Acute Exacerbation of COPD (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 history of heart failure) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy administration - Bronchodilator administration - Preparation for transport to nearest hospital with respiratory services