How to manage suspected heart attack chest pain
Other platforms explain it with text and video. In VMS you practice it on the patient.
In suspected heart attack, speed matters. The ECG decides the pathway.
Step by step
ECG within 10 minutes
12-lead, transmit or show right away. [1]
Aspirin
Chewed (162 to 325 mg) if no allergy or active bleeding. [1]
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]
Oxygen
Only if saturation is below 90% or breathless. [1]
IV and monitor
Watch for arrhythmias; AED or defibrillator ready. [1]
STEMI
Activate the cath lab or prealert per system. [1]
Common errors
- Late ECG.
- Nitroglycerin after sildenafil.
- Routine oxygen with normal saturation.
Practice it in VMS
In VMS 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.
VMS cases that train this skill
Sources
Facts and steps follow NASEMSO National Model EMS Clinical Guidelines; NREMT psychomotor skill sheets (EMT and Paramedic). VMS is not affiliated with these organizations. Updated: 2026-10-11.