Hafnarstræti 22, 600 Akureyri, ground floor of the pharmacy 'Apótek Akureyrar'. Two-story concrete building, built in 1965, with large glass windows. Main entrance is accessible directly from the street. No elevators. Street parking available, limited during peak hours. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6823° N, 18.0886° W. Nearest landmark: Akureyri Art Museum.
45-year-old male experiencing severe shortness of breath. Primary symptoms: Wheezing, coughing, difficulty speaking in full sentences, use of accessory muscles for breathing. Patient reports feeling tightness in his chest. Secondary symptoms: Mild cyanosis around lips, anxious demeanor, sweating. Patient is conscious but distressed. Medical history: Diagnosed with asthma since childhood, has inhalers. Medications: Salbutamol (Ventolin) inhaler as needed, Fluticasone (Flixotide) inhaler twice daily. Known allergy: Pollen. Last meal was a sandwich at 12:00.
Timeline: 1300 hours: Patient started feeling mild shortness of breath while walking outside. 1310 hours: Symptoms worsened, started wheezing and coughing. 1315 hours: Patient used his Salbutamol inhaler, with minimal relief. 1320 hours: Symptoms continued to worsen, difficulty speaking. 1322 hours: Patient entered the pharmacy for help, pharmacist called emergency services. 1325 hours: Current time, patient sitting on a chair in the pharmacy, struggling to breathe. Prior Events: Patient reports occasional asthma flare-ups, usually controlled with his inhaler. No recent illnesses or infections. Last asthma check-up 6 months ago, routine follow-up. Patient reports being exposed to pollen recently.
Initial Impression: Acute Asthma Exacerbation Justification for F2 Classification: - Significant respiratory distress with wheezing, accessory muscle use, and difficulty speaking - Patient's condition is deteriorating despite use of inhaler - Potential for rapid progression to respiratory failure - Time-sensitive condition requiring prompt medical intervention Differential Diagnoses: 1. Acute Asthma Exacerbation (high probability) 2. Anaphylactic Reaction (less likely, no known allergens other than pollen) 3. Pulmonary Embolism (less likely given presentation) 4. Acute Bronchitis (less likely given history of asthma) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration if available - Rapid assessment of airway, breathing, and circulation - Preparation for transport to nearest hospital with respiratory support