NREMT Emergency Medical Technician (EMT) Cognitive ExamCardiology & ResuscitationMedium
A 62-year-old female complains of sudden onset of severe, crushing chest pain that radiates to her left arm and jaw. She is diaphoretic and states she feels very nauseous. Her blood pressure is 140/90 mmHg, heart rate is 100 bpm, and respiratory rate is 20 breaths per minute. She has no known allergies and takes no medications. What is the most appropriate initial medication administration for this patient, assuming local protocols allow?
- AOxygen via nasal cannula at 2 L/min
- BAspirin 325 mg orally
- CNitroglycerin 0.4 mg sublingually
- DMorphine sulfate 2 mg intravenously
Show answer & explanationAnswer & explanation
Correct answer: B. Aspirin 325 mg orally
For a patient presenting with symptoms highly suggestive of acute myocardial infarction (AMI), aspirin is a critical initial medication. It works by inhibiting platelet aggregation, thereby reducing the size of the clot forming in the coronary artery. Nitroglycerin is often given after aspirin, and oxygen is only routinely indicated if the patient is hypoxic or in respiratory distress.
Why the other options are wrong
- A. Oxygen is only routinely indicated for patients with suspected AMI if they are hypoxic or in respiratory distress, not as a blanket initial treatment.
- C. Nitroglycerin is indicated for chest pain relief in AMI but typically follows aspirin and careful blood pressure assessment.
- D. Morphine sulfate is a pain reliever for AMI but is generally considered after aspirin and nitroglycerin, and if pain persists.
Aspirin in AMI
Aspirin is an antiplatelet medication given early in suspected Acute Myocardial Infarction (AMI) to prevent further clot formation in the coronary arteries.
- Inhibits platelet aggregation
- Reduces mortality and reinfarction rates
- Administered orally, typically 162-325 mg
- Contraindicated if true aspirin allergy or active bleeding
Memory trick: MONA doesn't always come in order; think ASAP!