Hafnarstræti 42, 600 Akureyri, ground floor apartment 1B. Three-story wooden building, constructed in 1955, recently renovated. Main entrance is street-level with a single door. No elevator. Parking available on the street. Building has a basic fire alarm system. Current conditions: 7°C, overcast, good visibility. GPS coordinates: 65.6829° N, 18.0897° W. Nearest landmark: Akureyri Art Museum.
3-year-old male child, experiencing difficulty breathing. Primary symptoms: Rapid breathing, wheezing, nasal flaring. Secondary symptoms: Mild cough, slight lethargy. Child is alert but agitated. Skin is pale with mild circumoral cyanosis. Child is sitting up on the couch. Medical history: History of mild asthma, treated with salbutamol inhaler as needed. Allergies: None known. Medications: Salbutamol inhaler (last dose 2 hours ago, 2 puffs). Last meal was a small snack 1 hour ago.
Timeline: 1400 hours: Child began experiencing mild cough and runny nose 1500 hours: Child's breathing became more rapid and labored 1530 hours: Child started wheezing and using accessory muscles to breathe 1545 hours: Mother administered 2 puffs of salbutamol inhaler 1600 hours: Current time, child's breathing has not improved significantly; mother calls emergency services Prior Events: Child had a mild cold last week, recovered without medical intervention. Has had 2 previous asthma exacerbations in the past year, both resolved with salbutamol. No recent hospitalizations. Regular pediatric check-ups.
Initial Impression: Acute Asthma Exacerbation Justification for F3 Classification: - Moderate respiratory distress with wheezing and accessory muscle use - Child is alert but showing signs of mild hypoxia (circumoral cyanosis) - Condition is time-sensitive but not immediately life-threatening - History of asthma and recent cold symptoms support this diagnosis Differential Diagnoses: 1. Acute Asthma Exacerbation (high probability) 2. Bronchiolitis (less likely given age and history) 3. Foreign Body Aspiration (less likely given no choking history) 4. Pneumonia (less likely given no fever) Required Actions: - Dispatch of ground EMS with BLS/ALS capabilities - Oxygen administration and monitoring - Further assessment of respiratory status - Possible administration of additional bronchodilators - Preparation for transport to nearest pediatric emergency department