A 67-year-old patient reports crushing chest pressure.

The correct answers are A. Give aspirin and E. Assist with nitroglycerin.

This patient is presenting with classic signs of acute coronary syndrome (ACS):

Crushing chest pressure

Hypertension

Normal respiratory rate

Adequate oxygen saturation (SpO₂ 94%)

Why A is correct (Aspirin):

Aspirin is a first-line treatment in suspected cardiac chest pain because it:

Inhibits platelet aggregation

Helps prevent further clot formation

NREMT-based guidelines state:

“Administer aspirin to patients with suspected cardiac chest pain unless contraindicated.”

Why E is correct (Nitroglycerin):

Nitroglycerin is also a primary early intervention (if prescribed and no contraindications), as it:

Dilates coronary arteries

Reduces cardiac workload

Relieves chest pain

Guidelines emphasize:

“Assist the patient with prescribed nitroglycerin if systolic BP is adequate.”

This patient’s BP (156/98) is sufficient for nitroglycerin administration.

Why the other options are incorrect:

B. CPAP: Indicated for respiratory distress (e.g., pulmonary edema), not isolated chest pain.

C. Oxygen: Not routinely indicated when SpO₂ is ≥94%; current guidelines recommend avoiding unnecessary oxygen.

D. Lay the patient supine: Patients with chest pain are typically kept in a position of comfort, often sitting upright.

Exact Extracts:

“Administer aspirin to patients with suspected acute coronary syndrome.”

“Assist with nitroglycerin if prescribed and blood pressure is adequate.”

“Oxygen should be administered if oxygen saturation is below 94% or signs of hypoxia are present.”