Hafnarstræti 18, 600 Akureyri, ground floor of a two-story wooden building. Built in 1950, recently renovated. Main entrance on the street level, no stairs. Street parking available. Building has basic fire detection system. Current conditions: 7°C, overcast, light wind. GPS coordinates: 65.6821° N, 18.0895° W. Nearest landmark: Hof Cultural and Conference Center.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Difficulty breathing, rapid and shallow respirations, wheezing. Secondary symptoms: Chest tightness, cyanosis around lips, anxiety. Patient is conscious but struggling to speak. Patient is sitting upright on a chair in his living room. Medical history: COPD diagnosed 5 years ago, hypertension, previous MI 2 years ago. Medications: Salbutamol inhaler (as needed), Tiotropium inhaler daily, Metoprolol 50mg daily, Aspirin 75mg daily. Known allergy to penicillin. Last meal was a sandwich at 12:00.
Timeline: 1330 hours: Patient started experiencing mild shortness of breath 1345 hours: Shortness of breath worsened, wheezing started 1350 hours: Patient used salbutamol inhaler, no improvement 1355 hours: Patient’s condition deteriorated, became increasingly anxious, chest tightness developed 1400 hours: Caller (patient’s son) arrived at the residence, found patient in distress, called emergency services 1403 hours: Current time, patient still struggling to breathe Prior Events: Patient has had several COPD exacerbations in the past year, requiring hospital admission. Last COPD flare-up was 3 months ago. Patient has been compliant with his medications. No recent illnesses or fever. Last medical check-up 2 weeks ago, routine follow-up.
Initial Impression: Acute COPD Exacerbation with Possible Respiratory Failure Justification for F2 Classification: - Patient presents with severe respiratory distress, cyanosis, and signs of possible respiratory failure - History of COPD and recent exacerbations indicate high risk - Time-sensitive condition requiring prompt intervention to prevent further deterioration Differential Diagnoses: 1. Acute COPD Exacerbation (most likely) 2. Acute Pulmonary Embolism (less likely, no sudden onset of pain) 3. Pneumonia (possible, but no fever reported) 4. Acute Myocardial Infarction (less likely, chest tightness is secondary to respiratory distress) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration and assisted ventilation if needed - Bronchodilator administration - Preparation for transport to nearest hospital with respiratory services