Adult Acute Coronary Syndrome

Question 1

Adult ACS - SpO2 goals in suspected acute coronary syndrome

Answer 1

No greater than 92%

Question 2

Adult ACS - ASA dose

Answer 2

160 mg PO chewed

Question 3

Adult ACS - ASA EMS contraindications

Answer 3

Hypersensitivity
Active GI bleed
Asthma with previous history of reaction to NSAIDS

Question 4

Adult ACS - Nitroglycerin dose in ACS

Answer 4

0.4 mg SL q 5 min prn or until BP < 100 mmhg

Question 5

Adult ACS - ACS with BP less than 90

Answer 5

Treat concurrently with shock protocol

Question 6

Adult ACS - When is morphine considered?

Answer 6

After 3 sprays of nitro

Question 7

Adult ACS - Morphine dose

Answer 7

2.5 mg q 5 min to max of 15 mg

Question 8

Adult ACS - Morphine contraindications

Answer 8

Hypersensitivity

Hypotension BP < 100

Question 9

Adult ACS - Nitroglycerin EMS contraindications

Answer 9

Hypotension BP < 100
Right ventricular infarcts
Patient taking phosphodiesterase inhibitors

Question 10

Adult ACS - Nitroglycerin infusion or patch indication

Answer 10

Ongoing chest discomfort and transport time greater than 30 minutes

Question 11

Adult ACS - Nitroglycerin infusion dose

Answer 11

20 mcg/min increase by 10 mcg/min q 5 min to a total max of 200 mcg/min

Question 12

Adult ACS - Nitroglycerin infusion set up

Answer 12

15 mg in 250ml D5W = 60 mcg/ml

Use Baxter control a flow with 60 gtts set

Question 13

Adult ACS - Nitroglycerin infusion administration

Answer 13

Use control a flow, 60 gtts set and 60 mcg/ml (15mg/250ml D5W) concentration

ml/hr = mcg/min