In EMS chest-pain protocols, which statement is correct?

• A. A typical aspirin dose is 325 mg; sublingual nitroglycerin onset is 1–3 minutes with about 20–30 minutes duration.
• B. Aspirin is never given; nitroglycerin is swallowed.
• C. Aspirin 81 mg is the standard; nitroglycerin lasts 4 hours.
• D. Aspirin 500 mg and nitroglycerin are not used.

Answer: (A)

In EMS chest-pain care, treating suspected acute coronary syndrome relies on two fast-acting measures: aspirin to inhibit platelets and nitroglycerin to dilate vessels and reduce heart workload. The standard aspirin dose is 325 mg, given as a chew to speed absorption and platelet inhibition. Chewing helps absorption reach the bloodstream quickly, which is crucial in the early treatment window.

Nitroglycerin is given sublingually so it acts quickly, with onset typically in about 1–3 minutes. The effect from a sublingual dose generally lasts around 20–30 minutes, providing relief from chest pain and reducing myocardial oxygen demand during the initial management period. It is not swallowed and is used only when blood pressure is adequate and there are no contraindications.

Options suggesting aspirin is never given, aspirin doses like 81 mg or 500 mg, nitroglycerin lasting several hours, or nitroglycerin being swallowed do not align with standard prehospital ACS protocols.