All Emergencies - Basic life support principles:

  1. Maintain an airway
  2. Assess breathing
  3. Monitor circulation
Monitor and record all vital signs.
Acute Coronary


  1. Almost always precipitated by an acute episode that increases the workload of the heart, including fear, pain or exertion.
  2. AMI (acute myocardial infarction) lasts longer than angina, is more severe, and does not respond well to nitroglycerin.
  3. Patient becomes diaphoretic, nauseated and lightheaded. Shortness of breath, generalized weakness, cool moist skin, and cyanosis of mucous membranes. Crushing chest pain.



  1. If the patient has no history of chest pain, or if the chest pain subsides but then subsequently returns, contact EMS. Also call if EMS is patient who has had previous angina asks you to contact them.  
  2. Most patients prefer to sit up or semi-upright. If blood pressure drops or consciousness is lost, place patient in supine position with feet elevated slightly.
  3. AMI patients usually maintain adequate airway & breathe spontaneously.
  4. Loosen constrictive clothing.
  5. Monitor & record heart rate & rhythm, and blood pressure.
  6. Administer oxygen.
  7. Administer 2 doses of either translingual or sublingual nitroglycerin.
    Avoid nitroglycerin if systolic < 90 or if marked bradycardia or marked tachycardia.
  8. If patient is not allergic to aspirin, have patient chew & swallow a 325 mg. aspirin tablet.
  9. Traditionally 2-5mg of morphine is administered every 5-15 minutes to manage the pain or administer nitrous oxide (35-65%). [Nitrous Oxide has been shown to be equal to the analgesic ability of morphine to manage the AMI pain.)
  10. Continue monitoring vital signs until EMS arrives.
  11. If patient loses consciousness, place in supine position & reassess and manage the steps of basic life support.