[SEOBowhntr]

Our facility doesn't have a formal protocol unfortunately, which is something I've tried to work on for about 2yrs to no avail as our mngmt and Cardiology groups are too busy bickering most of the time to approve anything. As for what I practice, and teach my nurses to practice, FIRST you must assess the pain, obtain some vital signs, and obtain and EKG before you do anything, except apply O2. From there, the information you have obtained should guide your intervention. For me the cut-off for NTG is usually any INF MI appearance on an EKG, or SBP < 100, or HR < 50. A thorough assessment often times rules in or out the etiology of the pain. Anyone with HOCM also is not a good candidate for NTG either. Often times the ability to read and EKG, voids out the need to even administer NTG because probably 50% or more of the pt's I've dealt with weren't having Cardiac Related Chest Pain.

[Rocky_LPN]

On my unit it goes: O2 2-4L NC, NTG SL 1tab q 5 x3, Morphine IVP, Call doc if un relieved

[midwestvintage]

Our unit protocol for CP R/O MI pt is O2 one nitro, stat EKG, can repeat the nitro up to 3, call Doc. They usually call back quickly but if pt really crumping we have a rapid response team we can call. The can order lab and meds and will contact doctors. Works very well.

[elizabeth5]

Does anyone have a standing order they can share?

[southernatheart]

We go by 'MONA'...morphine, o2, nitro, aspirin