string(11) "/protocols/"

Chest Pain 7.0

All Providers

  • Focused history and physical exam
    • Assess for signs or symptoms suggestive of ischemia or infarction
    • OPQRST mnemonic - (onset, provocation or palliation, quality, radiation, severity, timing)
    • Ask patient (male or female) if they have taken erectile dysfunction medication in the past 2 days
  • Cardiac monitor, ETCO2 if available, pulse oximetry, 12 lead EKG (transmit if possible)
  • Treatment Plan
    • Oxygen therapy only as needed to target 94%

ADULT

EMT
  • Aspirin 325 mg po if not allergic
  • Nitroglycerin 0.4 mg SL, or 1 NitroSpray SL every 5 minutes as long as chest pain symptoms persist and SBP >100 mmHg, maximum of 3 doses
    • Do not administer if use of erectile dysfunction medication in the previous 2 days
AEMT
  • Advanced airway if needed
  • Vascular access
  • If hypotension after nitroglycerin administration, administer 500 ml LR and withhold further nitroglycerin
  • Pain medications per Pain Management Protocol
Paramedic
  • **Contact OLMC for further instructions**

Pediatric (Not to exceed adult dose)

EMT
AEMT
  • Consider asthma, foreign body, infection, trauma
Paramedic
  • **Contact OLMC for further instructions**