Question: In the previous cardiac ischemia medical directive it said that if the patients symptoms resolved after the administration of nitro and then returned that you could administer another 6 sprays of nitro. I was wondering if this was still the case.

 Thanks for your question. You are absolutely correct, the current set of directives does not define what to do if chest pain resolves and then recurs. You are also correct that the "old" directives did define that each episode can be treated as a new episode and the nitroglycerin may be repeated (but not the ASA) as long as the other criteria are still met. Until such time as the "new" directives are revised, the SWORBHP Medical Council would recommend that paramedics should proceed as before and treat recurrent ischemic chest pain with nitroglycerin as indicated by the directive.

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Nitroglycerin (Nitro NTG)

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