Hafnarstræti 18, 600 Akureyri, second floor apartment 2B. A three-story wooden building constructed in 1955. Main entrance has a key code. No elevator, only a central stairwell. Street parking available. Building has a smoke alarm system. Current conditions: 7°C, clear skies, good visibility. GPS coordinates: 65.6822° N, 18.0897° W. Nearest landmark: Akureyri Art Museum.
28-year-old male, experiencing severe shortness of breath. Primary symptoms: severe dyspnea, wheezing, and chest tightness. Secondary symptoms: anxiety, rapid breathing, and inability to speak in full sentences. Patient is conscious but distressed. Skin is pale and diaphoretic. Patient is sitting upright on the edge of his bed. Medical history: Asthma diagnosed in childhood, seasonal allergies. Medications: Salbutamol inhaler (Ventolin) as needed, Fluticasone inhaler (Flovent) daily. No known allergies. Last meal was a sandwich at 13:00.
Timeline: 1400 hours: Patient felt mild chest tightness and slight shortness of breath 1415 hours: Symptoms worsened, wheezing started 1420 hours: Patient used his Salbutamol inhaler twice with no improvement 1425 hours: Symptoms continued to worsen; called emergency services 1427 hours: Current time, patient struggling to breathe, unable to speak full sentences Prior Events: Patient reports a recent upper respiratory infection two weeks ago, no recent hospitalizations for asthma. Has not been using his Fluticasone inhaler regularly. Last asthma check-up 6 months ago, routine follow-up. Patient lives alone.
Initial Impression: Severe Asthma Exacerbation Justification for F2 Classification: - Acute respiratory distress with significant symptoms (dyspnea, wheezing, chest tightness) - Lack of response to initial treatment (Salbutamol inhaler) - Potential for rapid deterioration and respiratory failure - Time-sensitive condition requiring prompt medical intervention Differential Diagnoses: 1. Asthma Exacerbation (high probability) 2. Acute Bronchitis (less likely given history of asthma) 3. Anaphylaxis (less likely, no known allergies or exposure) 4. Pneumothorax (less likely given symptoms) 5. Pulmonary Embolism (less likely given symptoms and patient history) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration and assisted ventilation if needed - Administration of bronchodilators and corticosteroids - Preparation for transport to nearest hospital with respiratory services