Discomfort/Pain of suspected cardiac origin

Question 0

Nitro SBP minimum

Answer 0

> 90 mmHG

Question 1

Nitro tab dose

Answer 1

0.4mg

Question 2

Nitro may be repeated every ____minutes

Answer 2

5

Question 3

Titrate subsequent NTG to pain relieve as long as SBP > ______

Answer 3

90

Question 4

Can you give nitro without an IV?

Answer 4

Yes….absence of an IV shall not preclude use of NTG as long as other criteria are met

Question 5

NTG shall not be given to pt who have taken _____ inhibitors ex ____ within the last ____ hours. If they have taken these start with ______

Answer 5

PDE-5
Viagra, Avenfil, Tadafil (cialis), Vardenafil
48 hours
Morphine

Question 6

ASA dose

Answer 6

320-325mg

Question 7

Nitroglycerine (NTG) _______tablet or equivalent spray sublingual if Systolic Blood Pressure >_____. May repeat every ______min. Titrate subsequent NTG to ________ as long as the SBP >_______ mmHG while simultaneously establishing IV access. Absence of an IV shall not preclude use of NTG as long as all other criteria are met.

Answer 7

0.4
90
5
pain relief 
90

Question 8

Nitro Caution

NTG shall _____ be given to patients who have taken ______ inhibitors (Name 3_____,_____,____) or equivalent within the last ______hours, start treatment with _________ in these patients

Answer 8

not
PDE-5
Viagra, Cialis, Levitra
48hours 
morphine

Question 9

Administer _____mg-_____mg _______ Aspirin (ASA) orally, except in cases of ________ or _______ to ASA. Concurrent _________ therapy is not a contraindication for ASA admin.

Answer 9

320-325mg
chewable
intolerance or allergy
anticoagulation

Question 10

The most appropriate facility for hemodynamically stable pt (SBP_____) who have a 12 lead ECG consistant with an acute myocardial infarction. is a facility providing interventional cardiac catheterization services. EX of 12 lead ECG computer interpretations reading “___________”, “Acute _______ ________”, “ST ______ _____ ___”, or “________” are accepted as consistent with an acute myocardial infarction.

Answer 10

> 90

Acute MI , Acute MI Suspected, ST elevation criteria met or STEMI

Question 11

Hemodynamically unstable pt __________ shall be transported to the ____ _____ ____ providing ________ ____ _____ services

Answer 11

SBP <90
time closest facility
interventional cardiac catheterization services

Question 12

pt should not have transport unduly delayed by attempts to obtain ______.
All cardiac monitor interpretations shall be relayed to the ________ facility prior to arrival.

Answer 12

12 lead ECG

receiving

Question 13

IF NTG is ___________ or after the third (________ administered) NTG, the pt does not have relief of chest discomfort/pain the paramedic _____ elect to admin pain medication per _________ ________.

Answer 13

paramedic
may
pain management

Question 14

Discomfort/pain of suspected cardiac origin - ALS (Just the rundown)

Answer 14

Pulse OX 
ECG
Nitro
ASA
IV 
12 lead 
Tx to Cath Lab
May give morphine.

Question 15

CP suspected Cardiac- Supplemental O2

Answer 15

Maintain SpO2 >94%

Use lowest concentration and flow rate

Question 15

CP suspected Cardiac-How many ASA and what is the dose

Answer 15

4 -81 mg chewable tablets

= 324mg

Question 15

CP suspected Cardiac- Administration of Narcotics

3- Indications

Answer 15

1) Severe Pain not relieved by O2 admin and 3 doses of NTG, or pt cannot take NTG because they are taking PDE-5.
2) SBP>90
3) RR>12
- not listed but allergic to NTG

Question 16

CP suspected Cardiac- Fentanyl
Dose
Repeat
Max

Answer 16

1mcg/kg Slow IV/IO
Repeat every 5 minutes
Max dose 2mcg/kg/min