Hafnarstræti 18, 600 Akureyri, third floor, apartment 3B. A five-story reinforced concrete building, constructed in 1995. Main entrance has a keypad lock and intercom system. Elevator and central staircase available. Street parking available, sometimes limited. Building has a central fire alarm system. Current conditions: 8°C, overcast, moderate visibility, dry roads. GPS coordinates: 65.6821° N, 18.0914° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Severe dyspnea, wheezing, and cyanosis around the lips. Patient is conscious but appears distressed and is struggling to speak. Secondary symptoms: Chest tightness, rapid breathing, and a productive cough with small amounts of white sputum. Medical history: Chronic obstructive pulmonary disease (COPD), hypertension, and a history of mild heart failure. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (twice daily), Lisinopril 10mg daily, and Metoprolol 25mg daily. No known allergies. Last meal was a light lunch at 13:00. Smoker for 40 years.
Timeline: 1400 hours: Patient reported feeling slightly unwell, with a mild cough. 1430 hours: Symptoms worsened, with increasing shortness of breath and wheezing. 1445 hours: Patient attempted to use his salbutamol inhaler, with minimal relief. 1450 hours: Patient's breathing became more labored, and he started to turn blue around the lips. 1455 hours: Patient called his son for help. Son called emergency services immediately. 1458 hours: Current time. Patient is sitting upright in a chair, struggling to breathe. Prior Events: Patient has had several exacerbations of COPD in the past year, requiring hospital admission. Last medical check-up was 2 months ago. No recent changes to medication. Patient has been experiencing a mild cold for the past 3 days.
Initial Impression: Acute Exacerbation of COPD with Respiratory Distress Justification for F2 Classification: - Patient is experiencing severe respiratory distress with cyanosis, indicating significant hypoxia. - History of COPD and recent exacerbations increases the risk of rapid deterioration. - Time-sensitive condition requiring prompt medical intervention and potential airway management. Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Acute Heart Failure (possible, given history) 3. Pneumonia (possible, given recent cold symptoms) 4. Pulmonary Embolism (less likely, no sudden onset of chest pain) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy initiation - Possible need for assisted ventilation - Preparation for transport to nearest hospital with respiratory services