Reference protocol
🫀 Cardiac emergency
CHEST PAIN PROTOCOL
Version May 20, 2022
PROTOCOL — CHEST PAIN
Does the situation correspond to one or the other of the following cases?
Case 1 — Victim > 35 years
Pain in the chest, felt as:
TightnessPressureVice-likeCrushingChokingFistIndigestion
⏱ Continuous duration < 12 hours
not related to trauma
not related to trauma
OR
Case 2 — Known heart disease
Pain known and continuous similar to previous pain already experienced in a victim with a diagnosis of heart disease.
⏱ Continuous duration < 12 hours
NO
Apply the medical
or trauma protocol
adapted to the situation
or trauma protocol
adapted to the situation
YES
🛑 🛑 Stop all activity
Loosen clothing · Promote position of comfort
Loosen clothing · Promote position of comfort
💊 Aspirin (ASA)
320 mg total
4 × 81 mg or 1 × 325 mg
To chew — single dose
If pain presumed cardiac
If not allergic & no recent hemorrhage
To chew — single dose
If pain presumed cardiac
If not allergic & no recent hemorrhage
💨 Nitroglycerin (NTG)
Spray
Help the victim use
their own spray
if available
According to eligibility criteria
their own spray
if available
According to eligibility criteria
📞 Call 911
Seek care at a hospital
Seek care at a hospital
Place the victim in a position of comfort
(prevent fall-related trauma)
(prevent fall-related trauma)
Reassess vital signs (ABC) frequently
until emergency services arrive
until emergency services arrive
⚡ If deterioration — Cardiac arrest
Immediately apply the C-A-B CPR protocol
and use the AED as soon as available
and use the AED as soon as available