Hafnarstræti 18, 600 Akureyri, ground floor of a two-story wooden building, built in 1920. Main entrance faces the street, with a small step up. Back entrance has a ramp for accessibility. Building has a basic fire alarm system. Weather is clear, 10°C, good visibility. GPS coordinates: 65.6821° N, 18.0895° W. Nearest landmark: Akureyri Art Museum.
62-year-old male, experiencing severe shortness of breath. Primary symptoms: Difficulty breathing, rapid and shallow respirations, audible wheezing, cyanosis around lips. Patient is sitting upright, leaning forward, and is visibly distressed. Secondary symptoms: Chest tightness, productive cough with small amounts of yellow sputum, mild confusion. Medical history: Chronic Obstructive Pulmonary Disease (COPD), hypertension, type 2 diabetes. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (twice daily), Metformin 500mg (twice daily), Lisinopril 10mg (daily). Allergies: Sulfa drugs. Last meal was lunch at 13:00.
Timeline: 1400 hours: Patient began experiencing mild shortness of breath 1415 hours: Symptoms worsened, patient used Salbutamol inhaler with no relief 1430 hours: Patient developed chest tightness and wheezing 1440 hours: Patient's breathing became rapid and shallow, with visible cyanosis 1445 hours: Caller contacted emergency services 1447 hours: Current time, patient is sitting upright, struggling to breathe Prior Events: Patient had a COPD exacerbation 3 months ago, treated with oral steroids and antibiotics. No recent changes in medication. Patient reports a mild upper respiratory infection for the past 3 days.
Initial Impression: Severe COPD Exacerbation with Respiratory Distress Justification for F2 Classification: - Respiratory distress with cyanosis indicates potential hypoxemia and requires urgent intervention - History of COPD with recent respiratory infection suggests acute exacerbation - Patient is conscious but distressed, requiring prompt medical attention Differential Diagnoses: 1. Acute COPD Exacerbation (high probability) 2. Pneumonia (possible, given recent infection) 3. Pulmonary Embolism (less likely, no reported chest pain or risk factors) 4. Acute Heart Failure (less likely, no history of cardiac issues) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration and ventilatory support if needed - Bronchodilator administration - Preparation for transport to nearest hospital with respiratory services