Hafnarstræti 22, 600 Akureyri, ground floor of a two-story wooden building built in 1955. Main entrance is street-level with a single wooden door. No elevator. No known security system. Street parking available. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6827° N, 18.0932° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath and chest tightness. Patient is conscious but agitated, speaking in short sentences. Skin is pale and diaphoretic. Patient has a history of COPD and is a current smoker. He reports using his inhaler with no relief. Secondary symptoms include a productive cough with yellow sputum. Patient is sitting upright in a chair in his living room. Medical history: COPD diagnosed 5 years ago, hypertension, previous myocardial infarction 2 years ago. Medications: Salbutamol inhaler as needed, Tiotropium inhaler daily, Aspirin 75mg daily, Ramipril 5mg daily. Allergies: Penicillin. Last meal was a light lunch at 13:00.
Timeline: 1400 hours: Patient started feeling increased shortness of breath. 1415 hours: Patient used his salbutamol inhaler, with no improvement. 1420 hours: Symptoms worsened, chest tightness developed. 1425 hours: Patient called his son for help. 1428 hours: Son arrived, called emergency services. 1430 hours: Current time, patient still struggling to breathe, sitting upright. Prior Events: Patient reports a recent upper respiratory infection 1 week ago. He has been using his inhalers more frequently over the past few days. He has a history of smoking 1 pack per day for 40 years. Last medical check-up 2 months ago, routine follow-up for COPD.
Initial Impression: Acute Exacerbation of COPD with Possible Respiratory Infection Justification for F2 Classification: - Patient experiencing severe respiratory distress, with potential for rapid deterioration - History of COPD and recent respiratory infection increases risk of complications - Time-sensitive condition requiring prompt medical evaluation and treatment Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pneumonia (likely given recent infection and productive cough) 3. Acute Coronary Syndrome (less likely, but must be considered given history of MI) 4. Pulmonary Embolism (lower probability, no risk factors reported) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration and monitoring - Bronchodilator administration if indicated - Preparation for transport to nearest hospital with respiratory services