Hafnarbraut 12, 780 Höfn, single-story residential building. Main entrance is at street level. No stairs. Parking available in front of the house. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 64.2524° N, 15.2075° W. Nearest landmark: Höfn Harbour.
72-year-old male, experiencing severe shortness of breath. Primary symptoms: Rapid and labored breathing, audible wheezing, cyanosis around lips. Secondary symptoms: Chest tightness, patient is anxious and agitated. Patient is sitting upright, struggling to breathe. Medical history: Chronic Obstructive Pulmonary Disease (COPD), diagnosed 5 years ago, hypertension, type 2 diabetes. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (twice daily), Metformin 500mg twice daily, Lisinopril 10mg daily. Allergies: Penicillin. Last meal was soup at 12:00.
Timeline: 1300 hours: Patient started feeling slightly short of breath 1315 hours: Shortness of breath worsened, patient used salbutamol inhaler with minimal relief 1330 hours: Patient's breathing became increasingly labored, with audible wheezing. Cyanosis around lips noticed 1335 hours: Patient called emergency services. Prior Events: Patient has had several exacerbations of COPD in the past year, requiring hospitalization. Last COPD exacerbation 2 months ago, treated with oral steroids and antibiotics. No recent changes in medication regimen. Last medical check-up 1 month ago, routine follow-up.
Initial Impression: Severe COPD Exacerbation Justification for F2 Classification: - Acute onset of severe respiratory distress with clinical signs of respiratory compromise (cyanosis, wheezing, labored breathing) - Patient has known history of COPD, increasing risk of rapid deterioration - Time-sensitive condition requiring prompt medical intervention and potential advanced airway management Differential Diagnoses: 1. COPD Exacerbation (high probability) 2. Acute Pulmonary Embolism (less likely, no chest pain reported) 3. Pneumonia (possible, but less likely given sudden onset) 4. Acute Heart Failure (less likely, no history of heart failure reported) Required Actions: - Dispatch of ground EMS with ALS capabilities - Oxygen administration and monitoring - Bronchodilator therapy (nebulized if available) - Preparation for transport to nearest hospital with respiratory services