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Approved
June 7, 2006 |
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Treatment
Guidelines |
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I.
Routine paramedic
care.
II.
With chest pain or
symptoms characteristic of, or suspicious of, cardiac etiology, consider obtain
12 lead EKG. (See 12 lead procedure guideline)
A.
Consider right side
precordial leads to identify Right Ventricular Infarct if 12-lead EKG is
suspicious for inferior wall Ischemia/Injury.
III. With chest pain or symptoms characteristic of, or suspicious of, cardiac etiology, with systolic BP greater than 100: **
A. Oxygen, liter flow at discretion of Paramedic, based on:
1. Patients level of distress.
2. Preexisting respiratory history.
B. Chewable aspirin, 324 mg
C.
Administer
*Nitroglycerin — 1-2 measured dose(s) (0.4- 0.8 mg) nitroglycerin spray.
i.
Monitor BP every 5
minutes.
ii.
If patient becomes
hypotensive, place in Trandelenberg position and administer 250 cc NS.
b.
Continue
administration of NTG 0.4 mg sublingual every 5 minutes until one of the
following end points is reached: **
i.
Until chest pain or
symptoms characteristic of, or suspicious of, cardiac etiology are resolved.
(If no 12 lead obtained or non-diagnostic 12 lead EKG)
ii.
Until 12 lead
EKG ST segment changes normalized. (If AMI is
suspected by 12-lead findings)
iii.
BP is or less than 100
mm Hg systolic.
D.
If no relief after SL NTG X3, consider pain
management with Morphine Sulfate ( Use
Pain Management Guideline)
DI.
CONTACT MEDICAL
DIRECTION FOR CONSIDERATION OF THE FOLLOWING:
a.
ADDITIONAL MORPHINE
SULFATE
b.
OTHER TREATMENT
OPTIONS.
NOTE:
*Prior to administration of nitroglycerin to any patient,
insure that the drug Viagra has not been ingested with in the last 24 hours.
Significant BP drops may occur. CONTACT MEDIAL DIRECTION PRIOR TO NITRO USE.
**If 12 lead EKG unavailable, treat based on symptoms.
Issue Date: 6/7/06 Signature:___________________________________
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