EMT- Basic Treatment Protocol
Chest Pain/Discomfort Acute Coronary Syndrome (ACS)
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Indications for this protocol include one or more of the following:
1. The classic symptom associated with an Acute Coronary Syndrome (ACS) is chest discomfort, but symptoms may also include discomfort in other areas on the upper body, shortness of breath, sweating, (diaphoresis), nausea, vomiting, and dizziness. Many patients complain of substernal chest pain, pressure or discomfort unrelated to an injury or other readily identifiable cause.
History of previous ACS/AMI with recurrence of similar symptoms. Any patient with a history of cardiac problems who experiences lightheadedness or syncope. Patients of any age with suspected cocaine abuse and chest pain. Atypical or unusual symptoms (other than chest discomfort) are more common in women, the elderly and Diabetic patients.
If patient has no history of allergy to aspirin and has no signs of active bleeding (i.e., bleeding gums, bloody or tarry stools, etc.), then administer 4 (four) 81 mg chewable aspirin orally (324 mg total). BLS: Perform Medical Assessment & Management Procedures Protocol 6201. Request ALS Back-Up if assessment leads you to continue with this protocol.
Obtain 12 lead EKG (If available) and transmit copy or computer interpretation to Medical Command and to the receiving facility (BLS 12Lead decision algorithm below).
If blood pressure > 100 mm/Hg systolic and patient has not taken Viagra or Levitra within last 24 hours (or Cialis within the last 72 hours), then contact Medical Command for the following orders:
Administer nitroglycerine 0.4 mg (1/150 gr) SL Repeat every 5 minutes until pain is relieved or until 3 (three) doses administered.
West Virginia Office of Emergency Medical Services - State EMT-Basic Protocols 6202 Chest Pain Final 09/01/96 Revised 12/05 Revised 08/06, Revised 04/15/2013