What is the dose/route for nitroglycerin?

• A. 1 tablet or spray sublingual; max 3 doses every 5 minutes if symptoms persist and administration criteria are met
• B. 1 tablet IV infusion
• C. 2 sprays sublingual every 10 minutes
• D. Oral tablet daily

Answer: (A)

Nitroglycerin for acute chest pain in the EMS setting is given sublingually. Each dose is 0.4 mg, delivered as either a tablet or a spray placed under the tongue. If symptoms persist after 5 minutes, administer a second dose, and if still needed, a third dose, for a maximum of three doses total. This route and dosing are used only if the patient is eligible (no contraindications and adequate blood pressure). The other options are not used in this setting: an IV infusion is not a BLS route, an oral tablet daily is for chronic management not acute treatment, and giving two sprays every 10 minutes doesn’t follow the standard 5-minute interval.