Hafnarstræti 18, 600 Akureyri, third floor, apartment 3B. A three-story concrete building constructed in 1965. Main entrance is accessible via a coded door (code: 1965). No elevator, only a central stairwell. Street parking available. Building is equipped with a basic fire alarm system. Current weather: 8°C, overcast, light wind. GPS coordinates: 65.6825° N, 18.0912° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Significant difficulty breathing, rapid shallow respirations, use of accessory muscles. Secondary symptoms: Chest tightness, productive cough with yellow sputum, mild cyanosis around lips. Patient is conscious but anxious. Medical history: COPD diagnosed 5 years ago, history of smoking (30 pack-years), hypertension. Medications: Salbutamol inhaler (2 puffs as needed), Fluticasone/Salmeterol inhaler (1 puff twice daily), Lisinopril 10mg daily. Allergies: Penicillin. Last meal was soup at 12:00.
Timeline: 1300 hours: Patient started feeling slightly short of breath. 1330 hours: Symptoms worsened, patient used salbutamol inhaler with minimal relief. 1345 hours: Patient’s breathing became more labored, started coughing up yellow sputum. 1350 hours: Patient called his son for help. 1355 hours: Son arrived, called emergency services. 1400 hours: Current time, patient is sitting upright on a chair, struggling to breathe. Prior Events: Patient has had multiple COPD exacerbations in the past year, requiring hospitalization. No recent infections reported. Last medical check-up 2 months ago, routine follow-up. Patient lives alone.
Initial Impression: Acute COPD Exacerbation Justification for F2 Classification: - Significant respiratory distress with signs of hypoxia (cyanosis), indicating potential life threat - Patient has known COPD, increasing the risk of rapid deterioration - Time-sensitive condition requiring prompt medical intervention and oxygen therapy Differential Diagnoses: 1. Acute COPD Exacerbation (high probability) 2. Pneumonia (possible given productive cough) 3. Pulmonary Embolism (less likely given no chest pain) 4. Acute Heart Failure (less likely given no history of heart failure) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy initiation - Bronchodilator administration - Preparation for transport to nearest hospital with respiratory services