In a patient with suspected acute coronary syndrome who has already received oxygen and established IV access, what is the next best medication to administer?

In a patient with suspected acute coronary syndrome who has already received oxygen and established IV access, what is the next best medication to administer?

• A. Aspirin
• B. Nitroglycerin
• C. Morphine
• D. Sedate the patient and synchronize cardiovert

Answer: (A)

In suspected acute coronary syndrome, the first priority after securing the airway, breathing, circulation, and establishing IV access is to start early antiplatelet therapy. Giving aspirin promptly is crucial because it directly reduces further thrombus formation by inhibiting platelet aggregation, and it has a proven impact on survival in ACS. The usual approach is a chewable dose of about 160–325 mg so the medication acts quickly via the oral mucosa. Nitrates can be used next if the patient’s blood pressure is stable and there are no contraindications, and they help relieve chest pain by dilating vessels. But nitrates don’t provide the same mortality benefit as aspirin, which is why aspirin is the best immediate choice. Morphine may be reserved for persistent pain after nitrates and carries potential risks, and sedation with immediate cardioversion is not indicated unless the patient is unstable or has a rhythm requiring electrical therapy.

In suspected acute coronary syndrome, the first priority after securing the airway, breathing, circulation, and establishing IV access is to start early antiplatelet therapy. Giving aspirin promptly is crucial because it directly reduces further thrombus formation by inhibiting platelet aggregation, and it has a proven impact on survival in ACS. The usual approach is a chewable dose of about 160–325 mg so the medication acts quickly via the oral mucosa.

Nitrates can be used next if the patient’s blood pressure is stable and there are no contraindications, and they help relieve chest pain by dilating vessels. But nitrates don’t provide the same mortality benefit as aspirin, which is why aspirin is the best immediate choice. Morphine may be reserved for persistent pain after nitrates and carries potential risks, and sedation with immediate cardioversion is not indicated unless the patient is unstable or has a rhythm requiring electrical therapy.