Hafnarstræti 18, 600 Akureyri. Ground floor of a two-story wooden building built in 1955. Main entrance on street level, no stairs. No elevator. Street parking available. Building has a basic fire alarm system. Current conditions: 7°C, clear skies, good visibility. GPS coordinates: 65.6827° N, 18.0889° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Difficulty breathing, rapid and shallow respirations, audible wheezing, using accessory muscles to breathe. Secondary symptoms: Pale skin, cyanosis around lips, increased heart rate, reported chest tightness. Patient is conscious but anxious. Patient is sitting upright in a chair in his living room. Medical history: Chronic Obstructive Pulmonary Disease (COPD), hypertension, history of smoking. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (twice daily), Ramipril 5mg daily. Known allergy to penicillin. Last meal was lunch at 13:00.
Timeline: 1530 hours: Patient started experiencing mild shortness of breath. 1545 hours: Symptoms worsened, patient used his Salbutamol inhaler with no relief. 1600 hours: Patient's breathing became very labored, developed chest tightness, called for help. 1605 hours: Current time, patient still experiencing severe respiratory distress. Prior Events: Patient has had multiple COPD exacerbations in the past, requiring hospitalization. Last COPD flare-up was 6 months ago. Patient has not had any recent illnesses or injuries. Routine medical check-up 2 months ago. Patient lives alone, but has a neighbour who checks on him daily.
Initial Impression: Acute COPD Exacerbation with Respiratory Distress Justification for F2 Classification: - Significant respiratory distress with increased work of breathing and cyanosis - Patient's history of COPD and recent symptom progression indicates a severe exacerbation - Time-sensitive condition requiring prompt medical intervention to prevent respiratory failure Differential Diagnoses: 1. COPD Exacerbation (high probability) 2. Acute Pulmonary Edema (less likely, no history of heart failure) 3. Pneumonia (less likely, no reported fever or productive cough) 4. Pulmonary Embolism (less likely, no risk factors, no sudden onset) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen therapy administration - Bronchodilator treatment initiation - Preparation for transport to nearest hospital with respiratory support