Hafnarstræti 19, 600 Akureyri, ground floor of a two-story wooden building constructed in 1955. Main entrance is accessible from the street. No elevator. One exit at the rear of the building. Building equipped with a basic fire alarm system. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6832° N, 18.0911° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Difficulty breathing, wheezing, chest tightness, using accessory muscles to breathe. Secondary symptoms: Anxiety, pale skin, mild confusion. Patient is conscious but distressed. Patient is sitting in a chair in his living room. Medical history: Chronic obstructive pulmonary disease (COPD), hypertension, type 2 diabetes. Medications: Salbutamol inhaler (as needed), Fluticasone inhaler (twice daily), Metformin 500mg twice daily, Amlodipine 10mg daily. Known allergy: Penicillin. Last meal was a light lunch at 13:00.
Timeline: 1415 hours: Patient began experiencing mild shortness of breath 1430 hours: Shortness of breath worsened, started wheezing 1440 hours: Patient reports chest tightness and increased anxiety 1445 hours: Patient called his son for help 1450 hours: Son arrived and called emergency services 1452 hours: Current time, patient still experiencing severe respiratory distress Prior Events: Patient has a history of COPD exacerbations. He was hospitalized for a similar episode 6 months ago. No recent infections or injuries. Last medical check-up was 2 months ago, routine follow-up. Patient lives alone, but his son lives nearby.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Patient experiencing significant respiratory distress with wheezing and accessory muscle use - High risk of respiratory failure if not promptly treated - Time-sensitive condition requiring urgent medical intervention Differential Diagnoses: 1. COPD Exacerbation (high probability) 2. Acute Pulmonary Edema (less likely given history) 3. Pneumonia (possible but less likely given lack of fever) 4. Pulmonary Embolism (less likely given gradual onset) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration - Bronchodilator administration - Preparation for transport to nearest hospital with respiratory support