Hafnarstræti 18, 600 Akureyri, ground floor of a two-story wooden building built in 1955. Main entrance is at street level, no steps. No elevator. Secondary exit at the rear of the building. Parking available on the street. Building is not equipped with a security system. Current conditions: 7°C, overcast, light wind. GPS coordinates: 65.6827° N, 18.0929° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe shortness of breath. Primary symptoms: Rapid and labored breathing, wheezing, chest tightness, unable to speak in full sentences. Secondary symptoms: Cyanosis around lips, anxiety, confusion. Patient is sitting upright, leaning forward. Medical history: COPD diagnosed 5 years ago, history of smoking. Medications: Salbutamol inhaler (2 puffs as needed), Beclomethasone inhaler (2 puffs twice daily), Tiotropium inhaler (1 puff daily). Allergies: None known. Last meal: Light lunch at 12:00.
Timeline: 1400 hours: Patient began feeling mildly short of breath 1415 hours: Shortness of breath worsened rapidly, accompanied by wheezing 1420 hours: Patient used Salbutamol inhaler with no relief 1425 hours: Patient called his son for help 1430 hours: Son arrived, called emergency services 1432 hours: Current time, patient is in severe respiratory distress Prior Events: Patient reports several exacerbations of COPD in the past year, requiring hospitalization twice. Last pulmonary function test was 6 months ago, showed moderate COPD. No recent infections. Last medical check-up 2 months ago, routine follow-up. Patient lives alone, son lives nearby.
Initial Impression: Acute COPD Exacerbation with Respiratory Distress Justification for F2 Classification: - Significant respiratory distress with cyanosis and altered mental status. - High risk of rapid deterioration requiring immediate medical intervention. - Time-sensitive condition needing oxygen and bronchodilator therapy. Differential Diagnoses: 1. Acute COPD Exacerbation (high probability) 2. Pneumonia (possible, less likely given no fever) 3. Pulmonary Embolism (less likely given history of COPD and lack of sudden onset) 4. Acute Heart Failure (less likely given no prior history of heart failure) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration initiation - Bronchodilator therapy - Continuous monitoring of vital signs - Preparation for transport to nearest hospital with respiratory services