NREMT Emergency Medical Technician (EMT) Cognitive ExamCardiology & ResuscitationMedium
A 55-year-old male complains of sudden onset of severe, crushing chest pain radiating to his left arm. He is pale, diaphoretic, and extremely anxious. His vital signs are BP 140/90 mmHg, HR 100 bpm, RR 20 bpm, SpO2 96% on room air. He denies any allergies and takes no medications. After administering oxygen via nasal cannula to maintain SpO2 >94%, what is the MOST appropriate next medication to consider for this patient, assuming local protocols allow?
- ANitroglycerin
- BAspirin
- COral glucose
- DAlbuterol
Show answer & explanationAnswer & explanation
Correct answer: B. Aspirin
This patient is presenting with symptoms highly suggestive of an acute myocardial infarction (AMI). Aspirin is a critical initial medication for AMI suspected patients as it inhibits platelet aggregation, reducing clot formation and limiting infarct size. It should be given as soon as possible, assuming no contraindications.
Why the other options are wrong
- A. Nitroglycerin is also indicated for chest pain, but aspirin is generally given first in AMI unless contraindicated, especially given the patient's blood pressure is not hypotensive.
- C. Oral glucose is for hypoglycemia, which is not indicated by the patient's presentation.
- D. Albuterol is a bronchodilator for respiratory distress due to bronchospasm, not cardiac chest pain.
Acute Myocardial Infarction (AMI) Initial Medications
Initial prehospital medication management for suspected AMI focuses on improving oxygenation, reducing cardiac workload, and preventing further clot formation.
- Oxygen for hypoxia or respiratory distress.
- Aspirin (162-324 mg chewable) to inhibit platelets.
- Nitroglycerin (sublingual) for chest pain and vasodilation (if BP allows).
- Morphine (ALS) for pain relief if nitro is insufficient.
Memory trick: MONA: Morphine, Oxygen, Nitro, Aspirin (but order matters!)