Hafnargata 15, 735 Norðfjörður. Two-story wooden house built in 1950. Main entrance is on the ground floor with two steps up. No elevator. Street parking available. No security features. Current conditions: 8°C, overcast, light wind, good visibility. GPS coordinates: 65.2088° N, 14.2011° W. Nearest landmark: Norðfjörður harbor.
76-year-old male, experiencing severe shortness of breath. Primary symptoms: Rapid, labored breathing, wheezing, use of accessory muscles. Patient reports a sudden onset of symptoms. Secondary symptoms: Mild chest tightness, productive cough with clear sputum. Patient is conscious but anxious. Skin is pale and slightly clammy. Patient is sitting upright in a chair. Medical history: COPD diagnosed 5 years ago, hypertension, history of smoking. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (twice daily), Amlodipine 5mg daily. Allergies: Penicillin. Last meal: Light lunch at 13:00.
Timeline: 1400 hours: Patient was resting at home. 1410 hours: Patient started experiencing shortness of breath, initially mild, worsening rapidly. 1415 hours: Patient used his Salbutamol inhaler, no significant improvement. 1420 hours: Patient’s breathing became more labored, developed wheezing and cough. 1425 hours: Caller (patient’s son) called emergency services. 1428 hours: Current time, patient still experiencing severe respiratory distress. Prior Events: Patient has had several COPD exacerbations in the past, requiring hospitalizations. Last COPD exacerbation was 6 months ago. No recent illnesses or injuries. Patient has not been compliant with his Fluticasone/Salmeterol inhaler regimen.
Initial Impression: Acute COPD Exacerbation Justification for F2 Classification: - Patient has a history of COPD with acute onset of severe respiratory distress - Use of accessory muscles and wheezing indicate significant respiratory compromise - Time-sensitive condition requiring prompt medical intervention Differential Diagnoses: 1. Acute COPD Exacerbation (high probability) 2. Pneumonia (possible, but less likely given acute onset without fever) 3. Pulmonary Embolism (less likely given lack of chest pain and risk factors) 4. Acute Heart Failure (possible, but less likely given patient’s history and symptoms) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration - Bronchodilator therapy - Preparation for transport to nearest hospital with respiratory services