Question: My question is regarding our chest pain protocol. There is a 48 year old male complaining of chest pain. It is substernal, 7/10, onset 1 hour, provoked at rest, radiates to left arm sitting steady.

O/E patient’s history is hypertension; vitals H/R 78 regular and full; breathing 20x / minute; B/P 138/99; conscious and alert x 3. Patient is not allergic to ASA, so he receives ASA.

History of nitro is in question. The patient states he was in hospital once with similar chest pain and doctor “gave me a spray of something for my chest pain”. When asked if it was nitro, the patient did not know name of medication.

Could this patient receive NTG or should we patch?