EMERGENCY

Question 1

Acute Chest Pain (possible cardiac) Initial Therapy

Answer 1

• Arrange transfer by ambulance to emergency department
• Obtsin IV access with 2 x large bore cannulas
• Aspirin 300mg PO STAT
• If haemodynamically stable
  —GTN spray 400-800mcg sublingual repeat every 5 min to a total of 3 sprays
• If persisting pain add opioid
  — Fentanyl 25-50mg repeat every 5-10 minutes OR
  — Morphine 2.5-5mg IV repeat every 5-10 minutes
• Oxygen therapy if SaO2 is <94%
• Ongoing monitoring vital signs
• Repeat ECG