Hafnarstræti 22, 600 Akureyri, ground floor of a two-story wooden building, built in 1950. Main entrance is street-level, no steps. No elevator. Parking available on street. Building has standard door lock. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6833° N, 18.0911° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe shortness of breath. Primary symptoms: Rapid, labored breathing, audible wheezing, chest tightness. Patient reports sudden onset of symptoms. Secondary symptoms: Mild confusion, pale skin, sweating. Patient is conscious but agitated. Patient is sitting upright in a chair in his office. Medical history: Asthma diagnosed in childhood, COPD diagnosed 5 years ago, history of smoking. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (twice daily), Theophylline 200mg daily. Known allergies: Penicillin. Last meal was a sandwich at 12:00.
Timeline: 1330 hours: Patient reports feeling slightly unwell, mild cough 1345 hours: Patient began to experience shortness of breath, symptoms worsened rapidly 1350 hours: Patient used his Salbutamol inhaler, no relief 1355 hours: Patient called his son for help, son arrived immediately 1400 hours: Current time, patient is in severe respiratory distress, son called emergency services Prior Events: Patient reports frequent exacerbations of COPD in the past year, requiring occasional use of oral steroids. Last medical check-up 2 months ago, routine follow-up. No recent infections or injuries. Patient lives alone, but son works nearby.
Initial Impression: Acute Exacerbation of COPD/Asthma Justification for F2 Classification: - Significant respiratory distress, rapid onset, failure to respond to initial treatment - Potential for rapid deterioration and respiratory failure - Time-sensitive condition requiring prompt intervention Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Acute Asthma Exacerbation (moderate probability) 3. Pulmonary Embolism (lower probability, no chest pain) 4. Pneumonia (lower probability, no fever reported) 5. Acute Heart Failure (lower probability, no history of heart disease) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy initiation - Bronchodilator administration - Preparation for transport to nearest hospital with respiratory services