There is NO NURSE LEAD nitro or MI treatment in ACLS - yes there is the ACS segment but that DOES NOT give you the authority to start medications. If you see an st segment elevation the Doctor needs to come and evaluate and write orders. Knowing how to read 12 Lead EKGs to diagnose and treat an MI is WELL out of our scope of practice. They didn’t even teach me that in my residency- just ALL the lethal ACLS and st segment elevation as well as MI symptoms to order a 12 lead. You can’t do a 12 lead without an order technically.