Hafnarstræti 23, 600 Akureyri, first floor, apartment 102. Three-story concrete building built in 1965, main entrance accessible via street level, no elevator, central stairwell. Street parking available. Building has basic fire safety equipment. Current conditions: 7°C, overcast, light wind. GPS coordinates: 65.6834° N, 18.0887° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath at home. Primary symptoms: Severe dyspnea, rapid and shallow breathing, productive cough with yellow sputum, use of accessory muscles. Secondary symptoms: Increased heart rate, pale and clammy skin, patient is anxious and agitated. Patient is sitting upright on the edge of his bed. Medical history: COPD diagnosed 5 years ago, hypertension, type 2 diabetes. Medications: Salbutamol inhaler (2 puffs PRN), Fluticasone/Salmeterol inhaler (1 puff BID), Metformin 500mg BID, Lisinopril 10mg daily. Known allergy to penicillin. Last meal was a light lunch at 13:00.
Timeline: 1500 hours: Patient started feeling unwell with mild shortness of breath 1530 hours: Symptoms worsened rapidly, difficulty speaking in full sentences 1545 hours: Patient started coughing up yellow sputum 1550 hours: Patient called emergency services 1552 hours: Current time, patient is struggling to breathe, very anxious Prior Events: Patient has had several COPD exacerbations in the past, last one 6 months ago requiring hospitalization. Patient has not been compliant with prescribed medications in the last week. No recent infections or injuries reported. Last doctor's visit was 1 month ago, routine follow-up.
Initial Impression: Acute COPD Exacerbation with Possible Respiratory Infection Justification for F2 Classification: - Severe respiratory distress with clear signs of respiratory compromise - Patient is symptomatic with increased work of breathing, requires urgent medical intervention - Potential for rapid deterioration if not treated promptly Differential Diagnoses: 1. COPD Exacerbation (high probability) 2. Pneumonia (possible, given productive cough) 3. Acute Pulmonary Embolism (less likely, no reported chest pain) 4. Acute Heart Failure (less likely, no history of heart failure) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration initiation - Bronchodilator treatment initiation - Monitoring of vital signs and level of consciousness - Preparation for transport to nearest hospital with respiratory support