I need help convincing a Doc

Coldfoot · Oct 31, 2002

Ok, not totally a nurse question but this board is my best source for knowledgeable medical people. I provide remote medical coverage in an industrial setting where a large portion of my potential pt's have HUGE cardiac risk factors. The soonest I can get help here is an hour and a half (a CC Medevac). The only Nitrate I have is SL Nitro spray. I think I need something a little longer acting, specifically Nitro Paste. Right now a NTG GTT is not an option. I need amunition to convince my med control Doc that this is really something I need. Any articles, referances or info will be appreciated, thanx:p

Gardengal · Nov 2, 2002

I don't really have one particular reference to site here, but would refer to the standard guidelines being used with EMS personnel for care of a suspected cardiac patient.

You might want to speak to the physician regarding the onset of action and duration of efficacy for both the NTG spray and the nitroglycerine paste. Perhaps you might mention that if the NTG spray works for the patient, in order to maintain the unloading effect of ntg on the patient to prevent further injury you wondered if maybe they would consider NTP and ask what dosage the MD thinks would be beneficial. I have found that frequntly I have better results in getting what I want for my patients if I suggest one thing in a broad way and then ask a specific question so that the MD feels that he made the suggestion.

You might also want to throw in something about giving an ASA to these patients as well.

Coldfoot · Nov 2, 2002

Thanks for the suggestion, ( this Doc really needs to think it was his idea). ASA and standard ACLS treatment is already what we do. The problem that I am finding is that NTP is not used prehospital. Being the only medical person around I am looking for a way to continuously administer Nitro without having to re-dose Q5min.:)