1. Acute Coronary Syndrome A VERMONT PROTOCOL 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 3. Vermont Protocol 4. General Considerations 5. EMT Standing Orders 6. AEMT Standing Orders 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 8. Important Info 9. PEARLS 10. PEARLS 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.