If chest pain is not relieved after three doses of nitroglycerine, what should be done next?

• A. One more dose of NTG may be tried
• B. Call 911 and transport the patient to the emergency department
• C. The person should be given two aspirin to chew
• D. A portable defibrillator should be located

Answer: (B)

When a patient experiences chest pain that is not relieved after three doses of nitroglycerine, the appropriate next step is to ensure the patient receives advanced medical evaluation and intervention as soon as possible. Calling 911 and transporting the patient to the emergency department is crucial because persistent chest pain after nitroglycerine indicates that the situation may be serious, potentially involving conditions such as acute coronary syndrome or myocardial infarction. Immediate medical assistance can provide advanced diagnostics and treatments that may be necessary to address the underlying cause.

While nitroglycerine is an important medication for treating angina, if pain persists after the established dosage, further doses may not be effective, and the risks of delaying treatment could outweigh the potential benefits. Chewing aspirin can be beneficial in certain situations related to cardiac events, but it does not replace the need for immediate emergency care when chest pain persists. Locating a portable defibrillator is also beneficial in cases of cardiac arrest, not as a first-line response to chest pain. Therefore, rapid transport to a medical facility is the most appropriate and lifesaving action in this scenario.