Hafnarstræti 18, 600 Akureyri, third floor apartment 3B. A five-story concrete building constructed in 1992. Main entrance has a key code and intercom system. Elevator and central staircase. Street parking is available. Building has a fire alarm system. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6823° N, 18.0914° W. Nearest landmark: Hof Cultural and Conference Center.
65-year-old male, experiencing severe shortness of breath. Primary symptoms: Difficulty breathing, rapid shallow respirations, wheezing, chest tightness. Patient reports feeling lightheaded and anxious. Secondary symptoms: Mild cough, pale skin. Patient is sitting upright on a chair in his living room. Medical history: Asthma diagnosed in childhood, COPD diagnosed 5 years ago, hypertension. Medications: Salbutamol inhaler (2 puffs as needed), Fluticasone/Salmeterol inhaler (1 puff twice daily), Lisinopril 10mg daily. Known allergy to penicillin. Last meal was a light lunch at 12:00.
Timeline: 1400 hours: Patient reports feeling slightly short of breath 1415 hours: Symptoms worsened, patient used salbutamol inhaler with no relief 1420 hours: Patient called his son for help 1425 hours: Son arrived, called emergency services 1428 hours: Current time, patient still struggling to breathe Prior Events: Patient reports several asthma exacerbations in the past year, last hospitalization for COPD exacerbation 6 months ago. No recent illnesses. Last check-up 2 months ago, routine follow-up. Patient lives alone, son lives nearby.
Initial Impression: Acute Exacerbation of COPD/Asthma Justification for F2 Classification: - Respiratory distress with increased work of breathing, wheezing, and reported chest tightness - Potential for rapid deterioration, requiring prompt medical intervention - Patient's medical history of asthma and COPD increases risk Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Acute Asthma Exacerbation (high probability) 3. Pulmonary Embolism (less likely, no reported chest pain or hemoptysis) 4. Pneumonia (less likely, no reported fever or productive cough) 5. Acute Heart Failure (less likely, no reported peripheral edema) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy initiation - Bronchodilator administration - Preparation for transport to nearest hospital with respiratory services