Hafnarstræti 18, 600 Akureyri, ground floor retail space. Two-story building with mixed retail and residential use, constructed in 1955. Main entrance on street level, no elevator. Street parking available, but limited. Building has standard commercial security features. Current conditions: 8°C, overcast, light wind. GPS coordinates: 65.6811° N, 18.0898° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe shortness of breath. Primary symptoms: Marked difficulty breathing, rapid and shallow respirations, audible wheezing. Secondary symptoms: Chest tightness, cyanosis around lips, patient is agitated and anxious. Patient is sitting upright, leaning forward. Medical history: Chronic obstructive pulmonary disease (COPD), hypertension, recent upper respiratory infection (URI). Medications: Salbutamol inhaler PRN, Fluticasone/Salmeterol inhaler BID, Lisinopril 10mg daily. Known allergy: Sulfa drugs. Last meal was a small sandwich at 12:00.
Timeline: 1330 hours: Patient started feeling unwell, reporting mild shortness of breath 1345 hours: Shortness of breath worsened, patient used his Salbutamol inhaler, with minimal relief 1400 hours: Patient’s breathing became more labored, chest tightness developed, and his lips started to turn blue 1405 hours: Patient called his son for help 1410 hours: Son arrived and called emergency services 1412 hours: Current time, patient still experiencing severe respiratory distress Prior Events: Patient was treated for a URI last week with antibiotics. He has been compliant with his COPD medications. He has been a smoker for 40 years.
Initial Impression: Acute Exacerbation of COPD with Possible Respiratory Failure Justification for F2 Classification: - Severe respiratory distress with cyanosis indicates a significant respiratory compromise - Patient has a history of COPD and recent URI, increasing risk of severe exacerbation - Time-sensitive condition requiring prompt medical intervention Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pneumonia (possible given recent URI) 3. Pulmonary Embolism (less likely, no chest pain reported) 4. Acute Heart Failure (less likely, no history of heart failure) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration and respiratory support - Continuous monitoring of vital signs - Preparation for transport to nearest hospital with respiratory services