Hafnarstræti 18, 600 Akureyri, ground floor apartment 1B. A three-story wooden building built in 1955. Main entrance has a small step. No elevator. Street parking available. Building has a basic fire alarm system. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6821° N, 18.0912° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe shortness of breath. Primary symptoms: Severe dyspnea, rapid breathing, audible wheezing, use of accessory muscles. Secondary symptoms: Mild chest tightness, productive cough with yellowish sputum, feeling of anxiety. Patient is conscious but appears distressed. Skin is pale and clammy. Patient sitting upright in a chair. Medical history: COPD diagnosed 5 years ago, hypertension, type 2 diabetes. Medications: Salbutamol inhaler (2 puffs PRN), Fluticasone/Salmeterol inhaler (1 puff BID), Metformin 500mg BID, Lisinopril 10mg daily. Known allergy to penicillin. Last meal was a light lunch at 13:00.
Timeline: 1400 hours: Patient started feeling slightly short of breath 1415 hours: Symptoms worsened, patient began using his salbutamol inhaler 1430 hours: No improvement after inhaler use, patient's breathing became more labored 1435 hours: Patient called his son for help 1440 hours: Son arrived and called emergency services 1442 hours: Current time, patient still struggling to breathe, sitting upright Prior Events: Patient reports a recent upper respiratory infection 3 weeks ago, treated with over-the-counter medications. Patient has had several exacerbations of his COPD in the past year, requiring hospitalization twice. Last medical check-up 2 months ago, routine follow-up.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Patient experiencing severe respiratory distress with significant symptomology - Potential for rapid deterioration if not treated promptly - Time-sensitive condition requiring immediate medical intervention Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pneumonia (possible, given recent respiratory infection) 3. Pulmonary Embolism (less likely, no reported chest pain or hemoptysis) 4. Acute Heart Failure (less likely, no history of heart failure) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy administration - Bronchodilator therapy administration - Preparation for transport to nearest hospital with respiratory services