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ACS-PRE-HOSPITAL MANAGEMENT

Cardiology

ACS-PRE-HOSPITAL MANAGEMENT

1. Give nonenteric coated ASA ( 162-325 mg) as bite and chew x1.

2. Nitroglycerin (tablets or spray) - if the drug is available, give only 1 dose, then: unimproved or worsening-give no more; improved: can repeat to max of 3 doses (at 3-5-minute intervals).

3. If the patient has taken a phosphodiesterase-S inhibitor (e.g., sildenafil or vardenafil) within 24 hrs (48 hrs for tadalafil), do not give nitroglycerin due to the risk of severe hypotension!

4. Be prepared to manage ventricular arrhythmias.


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REFERENCES

1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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