Hafnarstræti 19, 600 Akureyri, third floor apartment 3B. A five-story concrete building built in 1965, located in the city center. Main entrance is accessible via a code, 1978. There is an elevator and a central stairwell. Street parking available. Current weather conditions: 8°C, partly cloudy, good visibility. GPS coordinates: 65.6823° N, 18.0912° W. Nearest landmark: Hof Cultural and Conference Center.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Rapid and labored breathing, wheezing, cyanosis around lips. Secondary symptoms: Chest tightness, anxiety, productive cough with yellowish sputum. Patient is conscious but appears distressed. Patient is sitting upright on the edge of his bed. Medical history: COPD diagnosed 5 years ago, hypertension, history of smoking. Medications: Salbutamol inhaler (2 puffs as needed), Tiotropium inhaler (1 puff daily), Lisinopril 10mg daily. Allergies: No known allergies. Last meal was a light lunch at 13:00.
Timeline: 1400 hours: Patient started experiencing increased shortness of breath 1415 hours: Patient used his Salbutamol inhaler with no relief 1420 hours: Patient's breathing worsened, developed chest tightness 1425 hours: Patient started coughing up yellow sputum, became more anxious 1430 hours: Caller, the patient's son, arrived and called emergency services 1432 hours: Current time, patient is still experiencing severe respiratory distress Prior Events: Patient has had multiple COPD exacerbations in the past year, requiring hospitalization. Last medical check-up was 2 months ago, routine follow-up. Patient has a history of smoking 40 cigarettes a day for 45 years. Patient lives alone but his son lives nearby.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Patient experiencing significant respiratory distress with signs of hypoxia (cyanosis) - Unresponsive to initial treatment (Salbutamol inhaler) - History of COPD exacerbations requiring hospitalization - 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 history of DVT) 4. Acute Heart Failure (less likely, no history of heart failure) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy initiation - Bronchodilator administration - Preparation for transport to nearest hospital with respiratory services