Before administering nitroglycerin, what critical checks must be completed per EMS protocol?

• A. Confirm systolic blood pressure is adequate
• B. Check for PDE5 inhibitor use
• C. Obtain medical control if required
• D. All of the above

Answer: (D)

Before giving nitroglycerin, you must ensure the patient can tolerate it safely and that there are no interactions that could cause harm. The first check is confirming the systolic blood pressure is in the acceptable range per your EMS protocol; if it’s too low, nitroglycerin should not be administered. The second check is screening for PDE5 inhibitors (like sildenafil or tadalafil), since combining these with nitroglycerin can cause a dangerous drop in blood pressure. The third check is determining whether medical control is required to authorize administration or to confirm dosing and indications. When all three checks are satisfied, administration is appropriate per protocol.