Hafnarstræti 18, 600 Akureyri, third floor apartment 3B. A three-story concrete building, constructed in 1965. Main entrance is accessible by stairs or elevator. There is a buzzer system for access. Street parking available. The building has a basic fire alarm system. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6832° N, 18.0921° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, experiencing severe shortness of breath. Primary symptoms: Difficulty breathing, rapid and shallow respirations, audible wheezing, use of accessory muscles. Secondary symptoms: Chest tightness, anxiety, cyanosis around lips. Patient is conscious but struggling to speak in full sentences. Medical history: COPD diagnosed 5 years ago, history of smoking, hypertension. Medications: Salbutamol inhaler (2 puffs as needed), Tiotropium inhaler (1 puff daily), Amlodipine 10mg daily. Known allergy to penicillin. Last meal was a light lunch at 13:00.
Timeline: 1430 hours: Patient started feeling slightly short of breath while walking home from the grocery store. 1445 hours: Symptoms worsened rapidly, with increased difficulty breathing and chest tightness. 1450 hours: Patient used his salbutamol inhaler, with minimal relief. 1455 hours: Patient called his son for help, who then called emergency services. 1500 hours: Current time, patient is sitting upright in a chair, struggling to breathe. Prior Events: Patient reports several similar episodes in the past, usually resolved with his inhaler. He has been experiencing a mild cough for the past 3 days. No recent hospitalizations. Last medical check-up 6 months ago.
Initial Impression: Acute Exacerbation of COPD with Respiratory Distress Justification for F2 Classification: - Significant respiratory distress with wheezing, cyanosis, and accessory muscle use - Potential for rapid deterioration and respiratory failure - Time-sensitive condition requiring prompt intervention and oxygen therapy Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pneumonia (possible, given recent cough) 3. Pulmonary Embolism (less likely, no sudden onset of chest pain) 4. Acute Heart Failure (less likely, no prior history of heart failure) Required Actions: - Dispatch of ground EMS with ALS capabilities - High-flow oxygen therapy initiation - Bronchodilator therapy with nebulized salbutamol - Preparation for transport to nearest hospital with respiratory support