Hafnarstræti 18, 600 Akureyri. Ground floor of a two-story wooden building, built in 1920. Main entrance is on the street level, no steps. No elevator. Parking available on the street. Building has basic fire detection system. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6837° N, 18.0889° W. Nearest landmark: Akureyri Art Museum.
78-year-old male, experiencing severe shortness of breath. Primary symptoms: rapid and labored breathing, cyanosis around lips, use of accessory muscles for breathing. Secondary symptoms: chest tightness, audible wheezing, patient is anxious and agitated. Patient is sitting upright in a chair, conscious but struggling to breathe. Medical history: COPD diagnosed 15 years ago, heart failure. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (twice daily), Furosemide 40mg daily, Ramipril 5mg daily. Allergies: Penicillin. Last meal was a light lunch at 13:00.
Timeline: 1430 hours: Patient began experiencing increased shortness of breath 1440 hours: Symptoms worsened, including chest tightness and wheezing 1445 hours: Patient used his salbutamol inhaler, no relief 1448 hours: Patient's son called emergency services 1450 hours: Current time, patient struggling to breathe, cyanotic Prior Events: Patient has had several exacerbations of COPD in the past year, requiring hospital admissions. Last hospital admission was 2 months ago for pneumonia. Has been compliant with his medication regimen. No recent infections or injuries. Last medical check-up was 1 month ago, routine follow-up.
Initial Impression: Acute Exacerbation of COPD with Respiratory Distress Justification for F2 Classification: - Patient presenting with severe respiratory distress, cyanosis, and use of accessory muscles - High risk of respiratory failure if not promptly treated - Time-sensitive condition requiring immediate medical intervention Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pulmonary Embolism (less likely, no sudden onset of symptoms) 3. Acute Heart Failure (possible, given history, but respiratory distress is primary) 4. Pneumonia (possible, but no reported fever) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration initiation - Continuous monitoring of respiratory status - Preparation for transport to nearest hospital with respiratory services