Hafnarstræti 18, 600 Akureyri, third floor apartment 3B. A five-story reinforced concrete building, built in 1985. Main entrance has a keypad lock, code is 2468. There is one elevator and a central staircase. Street parking available. Building is equipped with smoke detectors. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6821° N, 18.0915° W. Nearest landmark: Hof Cultural and Conference Center.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Marked dyspnea, rapid shallow breathing, audible wheezing, and use of accessory muscles. Secondary symptoms: Mild chest tightness, anxiety, and productive cough with white sputum. Patient is conscious but appears distressed. Skin is pale and clammy. Patient sitting upright on the edge of his bed. Medical history: Chronic Obstructive Pulmonary Disease (COPD) diagnosed 5 years ago, history of smoking, hypertension. Medications: Salbutamol inhaler (2 puffs as needed), Fluticasone/Salmeterol inhaler (1 puff twice daily), Amlodipine 10mg daily. Known allergy to penicillin. Last meal was a light lunch at 13:00.
Timeline: 1430 hours: Patient started experiencing mild shortness of breath 1445 hours: Symptoms worsened, patient used his salbutamol inhaler with no relief 1500 hours: Patient's breathing became increasingly difficult, and he started to cough 1510 hours: Patient called his son for help 1515 hours: Son arrived, called emergency services 1517 hours: Current time, patient is struggling to breathe, still sitting upright Prior Events: Patient reports a recent upper respiratory infection 3 weeks ago. Has had several exacerbations of COPD in the past. Last medical check-up 6 months ago, routine follow-up. Patient lives alone, but son lives nearby.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Significant respiratory distress with potential for rapid deterioration - Use of accessory muscles and wheezing indicate severe airway obstruction - Time-sensitive condition requiring prompt medical intervention Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pneumonia (possible, given recent infection) 3. Pulmonary Embolism (less likely, no sudden onset of severe chest pain) 4. Acute Heart Failure (less likely, no history of heart disease) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration protocol initiation - Bronchodilator administration (nebulized if possible) - Preparation for transport to nearest hospital with respiratory support