Miðgarður 15, 700 Egilsstaðir, second floor apartment 203. Three-story concrete apartment building constructed in 1985. Main entrance requires a key or intercom. There is one elevator and a central stairwell. Parking is available in the street. The building is equipped with a basic fire alarm system. Current conditions: 8°C, overcast, light wind, moderate visibility. GPS coordinates: 65.2667° N, 14.3968° W. Nearest landmark: Egilsstaðir Swimming Pool.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Significant difficulty breathing, audible wheezing, and productive cough with yellow sputum. Secondary symptoms: Increased heart rate, patient reports feeling anxious and lightheaded. Patient is alert but distressed. Medical history: COPD diagnosed 5 years ago, hypertension, and type 2 diabetes. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (twice daily), Metformin 500mg (twice daily), Lisinopril 10mg (daily). Known allergy to penicillin. Last meal was a light lunch at 13:00.
Timeline: 1400 hours: Patient started experiencing mild shortness of breath, initially attributed to exertion after walking up stairs. 1415 hours: Shortness of breath worsened, with onset of wheezing and productive cough. 1430 hours: Patient used his Salbutamol inhaler, with minimal relief. 1445 hours: Patient's condition continued to deteriorate, with increased anxiety and lightheadedness. Patient called emergency services. 1450 hours: Current time, patient still experiencing severe respiratory distress. Prior Events: Patient reports having several exacerbations of COPD in the past year, requiring treatment with oral steroids. No recent hospitalizations. Last medical check-up 2 months ago, routine follow-up. Patient lives alone, but son lives nearby.
Initial Impression: Acute Exacerbation of COPD Justification for F2 Classification: - Significant respiratory distress with wheezing and productive cough - Potential for rapid deterioration requiring prompt intervention - Known history of COPD, increasing risk of respiratory failure - Time-sensitive condition requiring oxygen and possible bronchodilator therapy Differential Diagnoses: 1. Acute Exacerbation of COPD (high probability) 2. Pneumonia (possible, given productive cough) 3. Pulmonary Embolism (less likely, no chest pain) 4. Acute Heart Failure (less likely, no history of heart failure) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration upon arrival - Bronchodilator therapy as needed - Preparation for transport to nearest hospital