Can a Basic EMT Give Nitroglycerin?

Basic emergency medical technicians (EMTs) are the lowest level of emergency medical services (EMS) personnel, meaning they have the minimum certifications and requirements to provide emergency medical services in a prehospital setting. In most of the US, Basic EMTs can only administer nitroglycerin when it’s the patient’s own prescribed medication.

Just because a Basic EMT cannot administer nitroglycerin to a patient without their own prescription doesn’t mean they can’t administer other medications. If you’re preparing for a career in EMS, you must take the National Registry of Emergency Medical Technicians (NREMT) official exam. These exams can cover everything from when EMTS will use epinephrine to treat asthma to other paramedic pharmacology test questions.

Whether looking for resources on how EMTs treat anaphylaxis or how nitroglycerin should be administered, The Paramedic Coach is your go-to guide for all NREMT prep.

What Is Nitroglycerin?

Nitroglycerin is also known as ‘glycerine trinitrate.’ It is a medication usually used to treat angina‒a type of chest pain caused by a reduction in blood flow to the heart. It works by relaxing the vasculature and increasing oxygen and blood flow to the myocardium‒the thick middle layer of the heart.

When Do Patients Need Nitroglycerin?

Most EMS professionals may administer nitroglycerin when patients need relief for anginal chest pain, need to manage blood pressure, or to manage renal (kidney) or liver issues.

How Do EMTs Administer Nitroglycerin?

Basic EMTs cannot administer nitroglycerin unless the patient they are treating has already been prescribed it. Advanced EMTs (AEMTs) and paramedics typically administer nitroglycerin to patients as a sublingual (under the tongue) spray or tablet or as a transdermal (through the skin) paste. 

Nitroglycerin is also offered in extended-release oral tablets via intravenous (IV) infusion, rectal ointment, transdermal patch, and sublingual powder.

When Should You Avoid Nitroglycerin Administration?

When assessing your patient, ask if they have any current or known history of increased intracranial pressure (a growing pressure inside the skull), severe anemia, a right-sided myocardial infarction (heart attack), or allergies to nitroglycerin. Additionally, patients under twelve years of age should not take nitroglycerin.

Patients who have taken erectile dysfunction medications in the past twenty-four hours should not take nitroglycerin. Some medications include:

  • Viagra
  • Vardenafil
  • Tadalafil
  • Cialis
  • Levitra
  • Sildenafil
  • Staxyn
  • Stendra

Patients experiencing hypotension or are prone to hypotension should not take nitroglycerin.

Nitroglycerin Side Effects

While nitroglycerin has many benefits to patients, it does come with some side effects that you need to be mindful of. For example, the reason patients with low blood pressure should not take nitroglycerin is because this medication can cause hypotension, which can make your patient’s problems worse. 

Other side effects include:

  • Nausea
  • Headache
  • Dizziness
  • Flushing
  • Reflex tachycardia an increase in heart rate to increase a drop in blood pressure

Keep in mind that patients who have consumed alcohol just before or while taking nitroglycerin may experience an increase in hypotension. 

Learn About EMS Medications and More

Knowing all of the medications you’ll have access to as an EMT can be overwhelming, and the NREMT may not test you on every single medication and its uses! Luckily, The Paramedic Coach has your ‘cheat sheet’ to help you feel more confident in your training.

In the Video Vault, you will have access to our exclusive EMS Medications Mastery Course which comes with over fifty medication breakdowns that mirror the drug cards you’ll see on the job. When you sign up today, you can learn every single EMS medication and get access to our instant drug cards!

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