View source for ACUTE CORONARY SYNDROME-MANAGEMENT (A. PRE HOSPITAL)

===== [[Summary Article|'''SUMMARY''']] =====
<i>2013 ACC/AHA Guidelines for chest pain:</i>
<br/>1. Give non-enteric coated Aspirin (162-325 mg) as bite and chew x1.
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<br/>2. Nitroglycerin (tablets or spray): give only 1 dose. If unimproved or worsening: give no more. If improved: can repeat to max of 3 doses (at 3-5-minute intervals).
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<br/>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!
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<br/>4. Be prepared to manage ventricular arrhythmias. 


==Reference(s)==
Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. [https://amzn.to/3YHrI6K Get it on Amazon.]
<br/>Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. [https://amzn.to/3k7WSW0 Get it on Amazon.]
<br/>Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
<br/>Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].

[[Category:Acute Coronary Syndrome]]
[[Category:Cardiology]]
[[Category:Medicine]]