NREMT Emergency Medical Technician (EMT) Cognitive ExamMedical EmergenciesMedium
A 32-year-old male is experiencing sudden onset of severe, crushing chest pain that radiates to his left arm. He is pale, diaphoretic, and complains of shortness of breath. His blood pressure is 140/90 mmHg, pulse 100 bpm, respirations 20 bpm, and SpO2 94% on room air. He denies a history of cardiac problems. What is the MOST appropriate initial intervention?
- AAdminister high-flow oxygen via non-rebreather mask.
- BRapid transport to the nearest hospital.
- CAssist with nitroglycerin administration if available and prescribed.
- DAdminister aspirin 325 mg chewable.
Show answer & explanationAnswer & explanation
Correct answer: D. Administer aspirin 325 mg chewable.
The patient's symptoms are classic for an acute coronary syndrome (heart attack). Aspirin is a critical initial intervention as it inhibits platelet aggregation, reducing clot formation and improving outcomes in cardiac events. It should be given as soon as possible, provided there are no contraindications.
Why the other options are wrong
- A. Oxygen should be administered if SpO2 is below 94%, or if the patient is in respiratory distress. While his SpO2 is 94%, aspirin is a more direct and immediate intervention for the underlying cardiac event.
- B. Rapid transport is essential, but it should occur after or concurrent with life-saving interventions like aspirin administration, not instead of them.
- C. Nitroglycerin can be administered for chest pain, but only if prescribed to the patient (or per protocol) and after confirming blood pressure is adequate. Aspirin is generally given first if not contraindicated.
Acute Coronary Syndrome (ACS) Management
A spectrum of conditions associated with sudden, reduced blood flow to the heart, requiring immediate interventions like aspirin to reduce clot formation.
- Symptoms: chest pain (crushing, radiating), shortness of breath, diaphoresis, pallor.
- Aspirin is a primary intervention to inhibit platelet aggregation.
- Rapid transport to a cardiac-capable facility is critical.
Memory trick: MONA (Morphine, Oxygen, Nitroglycerin, Aspirin - in order)