Hafnarstræti 18, 600 Akureyri, ground floor of a two-story wooden building built in 1955. Main entrance is accessible from the street, no steps. Secondary entrance at the rear. No security features. Street parking available. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6821° N, 18.0894° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Labored breathing, rapid respiratory rate, wheezing, unable to speak in full sentences. Secondary symptoms: Pale skin, sweating, appears anxious. Patient sitting upright in a chair, clutching his chest. Medical history: Chronic Obstructive Pulmonary Disease (COPD), hypertension. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (twice daily), Lisinopril 10mg daily. Known allergy to penicillin. Last meal was a sandwich at 11:00.
Timeline: 1200 hours: Patient reports feeling slightly unwell, mild cough 1215 hours: Shortness of breath began, gradually worsening 1230 hours: Patient used his Salbutamol inhaler, no improvement 1240 hours: Symptoms worsened, patient unable to lie down 1245 hours: Patient called his son for help, son called emergency services 1250 hours: Current time, patient sitting in chair, struggling to breathe Prior Events: Patient has had several COPD exacerbations in the past year, requiring hospital admission. Last COPD exacerbation was 4 months ago. No recent infections or other illnesses. Last medical check-up 2 months ago, routine follow-up. Patient lives alone, son lives nearby.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Significant respiratory distress, patient unable to speak in full sentences - History of COPD, high risk for respiratory failure - Time-sensitive condition requiring prompt medical intervention Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pulmonary Embolism (less likely, no sudden onset) 3. Pneumonia (possible, but no fever reported) 4. Acute Heart Failure (less likely, no history of heart failure) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration - Bronchodilator therapy - Preparation for transport to nearest hospital with respiratory services