Hafnarstræti 18, 600 Akureyri, third floor, apartment 3B. A five-story concrete building built in 1965. Main entrance has a coded lock, code is 1965. There is an elevator and a central stairwell. Street parking available. The building has a basic fire alarm system. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6821° N, 18.0925° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Difficulty breathing, rapid and shallow respirations, audible wheezing, patient is using accessory muscles to breathe. Secondary symptoms: Agitation, pale skin, reported chest tightness. Patient is conscious but distressed. Patient is sitting upright on a chair in his living room. Medical history: COPD diagnosed 5 years ago, hypertension, history of smoking. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (twice daily), Amlodipine 10mg daily. No known allergies. Last meal was a light lunch at 13:00.
Timeline: 1430 hours: Patient started feeling mild shortness of breath 1445 hours: Shortness of breath worsened, began to experience wheezing 1450 hours: Patient used his Salbutamol inhaler, no improvement 1455 hours: Patient's condition deteriorated, increased difficulty breathing, agitation 1500 hours: Caller (patient's son) called emergency services 1502 hours: Current time, patient is still experiencing severe respiratory distress Prior Events: Patient had a mild exacerbation of COPD 3 months ago, treated with oral steroids at home. Patient reports missing several doses of his maintenance inhalers in the past week. Patient has a history of smoking, but quit 2 years ago. No recent illnesses or injuries. Last medical check-up 6 months ago, routine follow-up.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Severe respiratory distress with wheezing and accessory muscle use - Patient's history of COPD and recent missed doses of medications - Time-sensitive condition requiring prompt medical intervention Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Acute Bronchitis (less likely given chronic history) 3. Pulmonary Embolism (less likely, no sudden onset of chest pain) 4. Pneumonia (possible, but no reported fever or cough) 5. Acute Heart Failure (less likely, no reported leg swelling) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration - Bronchodilator treatment initiation - Continuous vital signs monitoring - Preparation for transport to nearest hospital with respiratory services