Hafnarstræti 18, 600 Akureyri, ground floor of a two-story wooden building. Constructed in 1930, renovated in 2005. Main entrance on the street level. No elevator. Street parking available. Building has basic security with a standard lock. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6833° N, 18.0897° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Rapid and labored breathing, wheezing, unable to speak in full sentences. Secondary symptoms: Pale skin, sweating, reported chest tightness. Patient is conscious but agitated. Medical history: COPD diagnosed 5 years ago, history of smoking. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (twice daily), Atorvastatin 20mg daily. No known allergies. Last meal was a light lunch at 12:00.
Timeline: 1300 hours: Patient started feeling slightly short of breath 1315 hours: Symptoms progressively worsened, patient used his salbutamol inhaler with no relief 1325 hours: Patient's breathing became very labored, he began sweating and feeling chest tightness 1330 hours: Caller (patient's son) called emergency services 1332 hours: Current time, patient is still experiencing severe respiratory distress Prior Events: Patient has had several exacerbations of COPD in the past year, requiring hospitalizations. He has been compliant with his medications, but has been smoking occasionally. No recent infections or other illnesses reported. Last medical check-up 2 months ago, routine follow-up.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Significant respiratory distress with wheezing and inability to speak in full sentences - Potential for rapid deterioration and respiratory failure - Time-sensitive condition requiring prompt medical intervention Differential Diagnoses: 1. Acute Exacerbation of COPD (most likely) 2. Acute Bronchitis (less likely given history) 3. Pneumonia (possible, but less likely given acute onset) 4. Pulmonary Embolism (less likely given absence of sudden onset and pleuritic chest pain) 5. Acute Heart Failure (less likely given known COPD history) Required Actions: - Dispatch of ground EMS with ALS capabilities - Administration of supplemental oxygen - Bronchodilator therapy initiation - Preparation for transport to nearest hospital with respiratory support