Hafnarstræti 18, 600 Akureyri, third floor, apartment 3B. Five-story reinforced concrete building constructed in 1995. Main entrance is accessed via a coded keypad (code 2468). One elevator and a central stairwell. Street parking available. Building has a fire alarm system. Current conditions: 7°C, overcast, moderate visibility. GPS coordinates: 65.6831° N, 18.0923° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Labored breathing, wheezing, cyanosis around lips, using accessory muscles to breathe. Patient is alert but anxious. Secondary symptoms: Chest tightness, productive cough with white sputum. Patient is sitting upright on the edge of his bed. Medical history: COPD diagnosed 5 years ago, hypertension, type 2 diabetes. Medications: Salbutamol inhaler (2 puffs as needed), Fluticasone/Salmeterol inhaler (1 puff twice daily), Metformin 500mg twice daily, Lisinopril 10mg daily. Known allergy: Penicillin. Last meal was a light lunch at 13:00.
Timeline: 1500 hours: Patient began experiencing mild shortness of breath, attributed it to exertion 1530 hours: Shortness of breath worsened, patient used his salbutamol inhaler with no relief 1600 hours: Patient reports increasing difficulty breathing, chest tightness, and cough 1615 hours: Caller (patient's son) arrived at the apartment and found his father in distress, called emergency services immediately 1620 hours: Current time, patient still experiencing severe respiratory distress Prior Events: Patient has had several COPD exacerbations in the past year, requiring hospital admission. Last COPD check-up 2 months ago, no significant changes noted. Patient has been compliant with his medication regimen. No recent infections or fever. Smoker for 40 years, quit 10 years ago.
Initial Impression: Acute Exacerbation of COPD with Respiratory Distress Justification for F2 Classification: - Patient experiencing significant respiratory distress, cyanosis and accessory muscle use - History of COPD exacerbations requiring hospital admission - Time-sensitive condition requiring prompt medical intervention Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pneumonia (possible, given productive cough) 3. Pulmonary Embolism (less likely, no sudden onset of chest pain) 4. Acute Heart Failure (less likely, no history of heart failure) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration - Bronchodilator therapy initiation - Preparation for transport to nearest hospital with respiratory services