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EMS: Administering Nitroglycerin

Tue, 13 Mar 2012|

Mike McEvoy shares some tips on different way of administering nitroglycerin to patients and goes over some concerns for responders when giving the drug.


Automatically Generated Transcript (may not be 100% accurate)

I welcome to training -- today we're gonna talk about. Administration on nitroglycerin. Nitroglycerin given to patients with chest pain. Comes in two different forms we see nitroglycerin spray that patients make Kerry. And we see nitroglycerin tablets. So want to talk first about this Greg. He'd give nitroglycerin spray by removing the oxygen device that's on the patient. Take in the spray and spraying it under the patient's -- Important part about this is that we have a tendency to lean in towards the patient when we remove the mask. And -- a nitroglycerin. And I want to show you first second. What the nitroglycerin spray looks like when it's rates. That -- Is all medication. If you're face is near the patient when you -- the nitroglycerin underneath there Tom. You -- a likelihood of inhaling the nitroglycerin. And having the medication take effect on you yourself as well as the patient. Not a good idea. The other form of nitroglycerin. And is nitroglycerin tablets. Now we've taken a patient's oxygen mask off. And we're gonna give him a nitroglycerin tablet. The problem nitroglycerin tablets often times that patience will take the bottle of tablets which he notices -- dark brown colored bottle. And I'll hold it in their pocket. The warmth of -- holding tablets in your pocket who caused that tablets to disintegrate prior to their age when they expire. One way to determine whether the nitro that a patient -- you of their own. Is effective or not just ask them if they've taken -- in the tablets when the tablets face bitter sweet. Sweet tablets that lost their potency. -- tablets actually are still effective. The other way to determine whether nitro is actually effective -- -- is whether it is -- patients like headache after they've taken. A nitroglycerin tablet like this require saliva to dissolve. And you want to be careful when you're taking in nitroglycerin tablet out of the bottle. You have some clothes on -- you're not absorbing the nitroglycerin medication through your hands. So we'll take a tablet out of the bottle. By putting one of the tablets into the cap. And then what we're gonna do is take an ordinary drinking straw. And use -- drinking straw as a mechanism of delivering a nitroglycerin to the patient. So we'll take the tablet. -- the drinking straw into the patient's -- Underneath this Tom. And drop the tablet. Into the straw. And that gives the medication to the patient okay. Nitroglycerin tablet dissolves in about two to three minutes. And what you would like to do is look for the effects of the night took less than five minutes after you've given tablets of the patient. So number think should happen if you get an upper chest pain. Anxious to meet some and -- -- chest pain. If you get -- at the lower. Blood pressure regardless of -- -- for that purpose or not take a blood pressure and you'd expect to see some change in the blood pressure. Nitroglycerin. Lowers blood pressure in virtually any patient we give it to so wanted to Contra indications are nitroglycerin. As if a person has a low blood pressure to Begin and that threshold tends to be a blood pressure a hundred. Hundred and twenties this dollar. Low what you would not want to give further dose and -- -- -- you can repeat that Madison spray or tablets. Every five minutes and most of the time by it I'm three doses have been given over the course of fifteen minutes' time. That's the maximum amount of nitroglycerin. And no further effects will be seeing them for their administration -- -- vocalist. If the patient blood pressure -- profoundly or if perhaps you've inhaled some nitroglycerin yourself. The treatment for that is to lay the person down. Until -- blood pressure recovers which will happen when the medication wears off in about five minutes the other concern about nitroglycerin. Does -- use -- -- but I -- ace inhibitors or drugs that patients may take for erectile dysfunction. And so those are drugs for example like Viagra. You wanna ask a patient they had used any of those medications with in the previous four hours or Viagra 24 hours -- Alice. And be cautious about giving nitroglycerin to patients who have taken any of those medications in a previous period of time. The reason for that is because those drugs are also. Blood pressure lowering drugs or nitroglycerin may exacerbate the effect of the blood pressure lower. Interestingly despite the warnings about erectile dysfunction drugs or -- master race and -- -- have never been reported deaths of patients who have taken notes medications along with -- equals. There have been some reports of extreme lowering blood pressure and in those situations you definitely gonna and up and putting the patient down. Doing things to raise your blood pressure back up for example raising their legs -- that wants to occur. That's ask prior to giving -- -- -- us currency don't put yourself in that situation. Thank you for watching training minutes on my Mac before he -- fire --

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