Hafnarstræti 23, 600 Akureyri, ground floor of a two-story wooden building, built in 1930. Main entrance has a single wooden door with a standard lock. No elevator. Street parking available. Building is equipped with smoke detectors. Current conditions: 8°C, overcast, good visibility. GPS coordinates: 65.6828° N, 18.0894° W. Nearest landmark: Akureyri Art Museum.
65-year-old male, sudden onset of severe shortness of breath. Primary symptoms: Difficulty breathing, rapid and shallow respirations, audible wheezing, use of accessory muscles. Secondary symptoms: Anxiety, cyanosis around lips, unable to speak in full sentences. Patient is sitting upright in a chair, appears distressed. Medical history: Asthma diagnosed in childhood, COPD diagnosed 5 years ago, previous hospitalization for exacerbation of COPD 6 months ago. Medications: Salbutamol inhaler 2 puffs as needed, Fluticasone inhaler 2 puffs twice daily, Tiotropium inhaler 1 puff daily. Allergies: Penicillin. Last meal was lunch at 13:00. Patient was watching TV when symptoms started.
Timeline: 1430 hours: Patient was watching TV, started to feel slightly short of breath. 1435 hours: Shortness of breath worsened rapidly, developed audible wheezing. 1437 hours: Patient tried using his salbutamol inhaler, no relief. 1440 hours: Patient called his son for help. 1442 hours: Son arrived, found patient in severe distress, called emergency services. 1445 hours: Current time, patient is sitting upright, struggling to breathe. Prior Events: Patient reports a cold last week, but felt better until today. Patient has been compliant with his medications. No recent changes in medication dosages. Patient has been smoking for 40 years, approximately 1 pack per day. Patient lives alone, son lives 10 minutes away.
Initial Impression: Acute Exacerbation of COPD/Asthma Justification for F2 Classification: - Significant respiratory distress with signs of hypoxia (cyanosis) - Failure of initial self-treatment with bronchodilator - History of COPD/Asthma with previous exacerbations - Time-sensitive condition requiring immediate medical intervention to prevent respiratory failure Differential Diagnoses: 1. Acute Exacerbation of COPD (most likely) 2. Acute Asthma Exacerbation (possible, given history) 3. Pulmonary Embolism (less likely, no chest pain reported) 4. Pneumonia (less likely, no fever reported) 5. Acute Heart Failure (less likely, no history of heart disease) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration and ventilatory support if needed - Bronchodilator therapy with nebulized medications - IV access and administration of corticosteroids if needed - Preparation for transport to nearest hospital with respiratory care services