Hafnarstræti 18, 600 Akureyri. Ground floor of a two-story wooden building built in 1920. Main entrance is street-level with a single door. No elevator. Street parking available. Building has a basic fire alarm system. Current conditions: 8°C, clear skies, good visibility. GPS coordinates: 65.6823° N, 18.0912° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe shortness of breath. Primary symptoms: Difficulty breathing, rapid and shallow respirations, audible wheezing, using accessory muscles. Secondary symptoms: Cyanosis around lips, chest tightness, anxiety. Patient is conscious but appears distressed. Patient is sitting upright in a chair. Medical history: Asthma diagnosed in childhood, COPD, history of smoking (quit 5 years ago), hypertension. Medications: Salbutamol inhaler (2 puffs PRN), Fluticasone inhaler (2 puffs BID), Lisinopril 10mg daily, Atorvastatin 20mg daily. Known allergy to penicillin. Last meal was a light lunch at 12:00.
Timeline: 1300 hours: Patient reports feeling slightly short of breath while walking home from the store. 1315 hours: Shortness of breath worsened, started using Salbutamol inhaler with minimal relief. 1320 hours: Patient’s breathing became more labored, developed chest tightness. 1325 hours: Caller, the patient's son, arrived and called emergency services. 1327 hours: Current time, patient is struggling to breathe, cyanotic around the lips. Prior Events: Patient reports several exacerbations of COPD in the past year, requiring oral corticosteroids. No recent infections or fever. Last medical check-up 2 months ago, routine follow-up. Patient lives alone, but son lives nearby.
Initial Impression: Severe Asthma/COPD Exacerbation Justification for F2 Classification: - Respiratory distress with signs of airway obstruction - Potential for rapid deterioration requiring immediate medical intervention - Patient’s history of asthma and COPD increases the risk of severe respiratory compromise Differential Diagnoses: 1. Acute Asthma Exacerbation (high probability given history) 2. COPD Exacerbation (high probability given history) 3. Pulmonary Embolism (less likely given the gradual onset) 4. Acute Myocardial Infarction (less likely given no reported chest pain) 5. Pneumonia (less likely given no reported fever or cough) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration - Bronchodilator therapy - Preparation for transport to nearest hospital with respiratory support