Under what condition may an EMT administer nitroglycerin for chest pain?

• A. If SBP is less than 100 mmHg
• B. If there is no history of chest pain
• C. If heart rate is over 150
• D. If prescribed to the patient

Answer: (D)

Nitroglycerin for chest pain is given only when the patient has a current prescription for nitroglycerin and the EMS protocol allows its administration. This ensures the medication, dose, and timing are already approved for that patient, reducing the risk of inappropriate or unsafe use. Other scenarios described—low systolic blood pressure, lack of chest pain history, or tachycardia alone—do not establish the proper authorization to give nitro. The key gatekeeper is having a prescribed nitroglycerin for that patient, with the clinician following protocol and assessing hemodynamics (such as keeping systolic BP above a safe threshold) before administration.