Hafnarstræti 91, 600 Akureyri, third floor apartment 3B. Five-story concrete building constructed in 1985. Main entrance has a key code. There is an elevator and a central stairwell. Street parking is available. The building has a fire alarm system. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6828° N, 18.0886° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Difficulty breathing, wheezing, productive cough with yellow sputum, chest tightness. Secondary symptoms: Increased heart rate, anxiety, pale skin. Patient is conscious but struggling to speak in full sentences. Patient is sitting upright on the edge of his bed. Medical history: COPD diagnosed 5 years ago, hypertension, type 2 diabetes. Medications: Salbutamol inhaler (as needed), Seretide inhaler (2 puffs twice daily), Metformin 500mg twice daily, Lisinopril 10mg daily. Allergies: Penicillin. Last meal was a small lunch at 13:00.
Timeline: 1400 hours: Patient began feeling slightly short of breath. 1430 hours: Symptoms worsened, developed wheezing and productive cough. 1445 hours: Patient used his salbutamol inhaler with minimal relief. 1450 hours: Patient called his son for help. 1455 hours: Son arrived and called emergency services. 1500 hours: Current time, patient still in respiratory distress. Prior Events: Patient reports a recent upper respiratory infection that started 3 days ago. He has been using his salbutamol more frequently over the last 24 hours. He has a history of occasional exacerbations of his COPD, usually managed at home with increased inhaler use. Last medical check-up was 6 months ago for routine diabetes follow-up. Patient lives alone, but his son lives nearby.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Significant respiratory distress with wheezing and productive cough. - Patient is symptomatic despite using rescue inhaler. - Potential for rapid deterioration and respiratory failure. - Time-sensitive condition requiring prompt medical intervention. Differential Diagnoses: 1. Acute Exacerbation of COPD (most likely) 2. Pneumonia (possible, given recent URI) 3. Pulmonary Embolism (less likely, no sudden onset of pleuritic chest pain) 4. Acute Heart Failure (less likely, no history of heart failure) Required Actions: - Dispatch of ground EMS with ALS capabilities. - Oxygen administration and monitoring. - Bronchodilator therapy. - Preparation for transport to nearest hospital with respiratory services.