Hafnarstræti 18, 600 Akureyri, third floor apartment 3B. A three-story concrete building constructed in 1965, with a single main entrance requiring a key. No elevator, only a central stairwell. Street parking available. Building equipped with a basic fire alarm system. Current conditions: 7°C, overcast, moderate wind. GPS coordinates: 65.6821° N, 18.0889° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing acute onset of severe shortness of breath and chest tightness. Patient is conscious but appears anxious and is struggling to speak full sentences. Skin is pale and clammy. Patient reports a history of COPD and asthma. He is using an inhaler but reports no relief. Secondary symptoms: Mild wheezing, productive cough with clear sputum. Patient is sitting upright on a chair in his living room. Medical history: COPD diagnosed 10 years ago, asthma diagnosed in childhood, hypertension, previous myocardial infarction 5 years ago. Medications: Salmeterol/Fluticasone inhaler 50/250 mcg two puffs twice daily, Albuterol inhaler as needed, Metoprolol 50mg daily, Aspirin 75mg daily. Allergies: None known. Last meal was a light lunch at 13:00.
Timeline: 14:00 hours: Patient was resting at home when he started experiencing increased shortness of breath. 14:05 hours: Patient used his Salmeterol/Fluticasone inhaler with no relief. 14:10 hours: Patient used his Albuterol inhaler, also with no relief. 14:15 hours: Symptoms worsened, and he started experiencing chest tightness. 14:18 hours: Patient called his son for help. 14:20 hours: Son arrived and called emergency services. 14:22 hours: Current time, patient is still experiencing severe respiratory distress. Prior Events: Patient reports an increase in respiratory symptoms over the past 3 days, attributing it to the changing weather. No recent fever or illness. Last medical check-up 6 months ago, routine follow-up. Patient lives alone, but his son lives nearby.
Initial Impression: Acute Exacerbation of COPD/Asthma with Possible Cardiac Involvement Justification for F2 Classification: - Acute onset of severe respiratory distress with potential for rapid deterioration - Patient's history of COPD, asthma, and previous MI increases risk - Time-sensitive condition requiring prompt medical intervention Differential Diagnoses: 1. Acute Exacerbation of COPD/Asthma (high probability) 2. Acute Myocardial Infarction (possible, given chest tightness and history) 3. Pulmonary Embolism (less likely given gradual onset) 4. Pneumonia (less likely given no fever or recent illness) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration and monitoring - Bronchodilator therapy initiation - Cardiac monitoring and assessment - Preparation for transport to nearest hospital with cardiac and respiratory services