EMS Today

Hold the Nitro... Or Don‘t


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This week, Bradley, Eric and David come together for a conversation over a case study. In this case, study we take a look at the treatment and transportation of a 56 year old who is complaining of chest pain; and subsequent 12-lead confirms that. Would you administer the nitroglycerin or hold for another treatment?
References
Prehospital Nitroglycerin Safety in Inferior ST Elevation Myocardial Infarction
https://pubmed.ncbi.nlm.nih.gov/26024432/
NTG administration to patients with chest pain and inferior STEMI is not associated with a higher rate of hypotension compared to patients with STEMI in other territories.
 
The Era of Reperfusion
https://www.ahajournals.org/doi/10.1161/circ.102.suppl_1.I-172
 JEMS
https://www.jems.com/training-videos/nitro-in-an-inferior-mi/
Inferior Wall Acute Myocardial Infarction: Not as Preload Dependent as Once Thought?
https://www.researchgate.net/publication/312102992_Inferior_Wall_Acute_Myocardial_Infarction_Not_as_Preload_Dependent_as_Once_Thought
https://pubmed.ncbi.nlm.nih.gov/28089058/
Effect of early treatment with anti-hypertensive drugs on short and long-term mortality in patients with an acute cardiovascular event
https://pubmed.ncbi.nlm.nih.gov/19821384/
...more
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