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Acute
Coronary
Syndrome
A VERMONT PROTOCOL REVIEW
Objectives of this review
▪ To review Vermont Protocol regarding ACS
▪ To review how and when Nitroglycerin should be administered
▪ To review other medications related to ACS
Vermont Protocol
General Considerations
EMT Standing Orders
AEMT Standing Orders
Why the Difference?
▪ Pt has been prescribed Nitroglycerin by their Physician
▪ If a pt has never taken Nitroglycerin, their reaction is unknown
▪ If the pt is not upfront regarding other medications, there could be
a negative reaction
▪ If a pt is suffering from an Inferior or Right-sided MI, they may have
a negative reaction
Important Info
PEARLS
PEARLS
Aspirin Administration
▪ Administer ASA as soon as possible – before Nitroglycerin
▪ Chewing ASA is the quickest method of administration
▪ If the pt takes a daily 81mg ASA, administer an additional 3
tablets (243mg) to equal a dose of 324mg
Take Home Points
▪ Nitroglycerin can be dangerous!
▪ An EMT can assist a pt who is prescribed Nitro by their Physician
▪ An AEMT can administer Nitro from the Ambulance Med Box only
after an IV line has been established. If an IV cannot be
established, then no Nitro can be administered.
▪ Aspirin, not Nitro will potentially save a persons life with ACS
▪ ALWAYS feel free to call Medical Control if we are unsure about a
treatment.

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Acute coronary syndrome Review

  • 2. Objectives of this review ▪ To review Vermont Protocol regarding ACS ▪ To review how and when Nitroglycerin should be administered ▪ To review other medications related to ACS
  • 7. Why the Difference? ▪ Pt has been prescribed Nitroglycerin by their Physician ▪ If a pt has never taken Nitroglycerin, their reaction is unknown ▪ If the pt is not upfront regarding other medications, there could be a negative reaction ▪ If a pt is suffering from an Inferior or Right-sided MI, they may have a negative reaction
  • 11. Aspirin Administration ▪ Administer ASA as soon as possible – before Nitroglycerin ▪ Chewing ASA is the quickest method of administration ▪ If the pt takes a daily 81mg ASA, administer an additional 3 tablets (243mg) to equal a dose of 324mg
  • 12. Take Home Points ▪ Nitroglycerin can be dangerous! ▪ An EMT can assist a pt who is prescribed Nitro by their Physician ▪ An AEMT can administer Nitro from the Ambulance Med Box only after an IV line has been established. If an IV cannot be established, then no Nitro can be administered. ▪ Aspirin, not Nitro will potentially save a persons life with ACS ▪ ALWAYS feel free to call Medical Control if we are unsure about a treatment.