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Emergencies and resuscitation

How to manage suspected heart attack chest pain

Other platforms explain it with text and video. In Making Synapses you practice it on the patient.

MD / DOPANursing (NCLEX)EMS (NREMT)
Practice it in VR with Blocky

In suspected heart attack, speed matters. The ECG decides the pathway.

Step by step

  1. ECG within 10 minutes

    12-lead, transmit or show right away. [1]

  2. Aspirin

    Chewed (162 to 325 mg) if no allergy or active bleeding. [1]

  3. Nitroglycerin

    If systolic pressure is adequate per protocol and no erectile dysfunction drugs in the last 24 to 48 hours; caution with right ventricle infarction. [1]

  4. Oxygen

    Only if saturation is below 90% or breathless. [1]

  5. IV and monitor

    Watch for arrhythmias; AED or defibrillator ready. [1]

  6. STEMI

    Activate the cath lab or prealert per system. [1]

Common errors

Practice it in Making Synapses

In Making Synapses you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.

Making Synapses cases that train this skill

24 Making Synapses cases train this skill: open the case library

Sources

  1. NASEMSO National Model EMS Clinical Guidelines
  2. NREMT psychomotor skill sheets (EMT and Paramedic)

Facts and steps follow NASEMSO National Model EMS Clinical Guidelines; NREMT psychomotor skill sheets (EMT and Paramedic). Making Synapses is not affiliated with these organizations. Updated: 2026-10-11.