The correct answers are D. Aspirin administration and E. Attaching AED pads.

This patient is presenting with classic signs of acute coronary syndrome (ACS):

Crushing, midsternal chest pain

Onset with exertion

Age and risk profile

D. Aspirin administration is a priority intervention. Aspirin helps by inhibiting platelet aggregation and limiting clot formation in coronary arteries.

NREMT-aligned guidance states:

“Administer aspirin to patients with suspected cardiac chest pain.”

E. Attaching AED pads is also correct because patients with suspected cardiac ischemia are at risk for sudden cardiac arrest. Continuous cardiac monitoring (via AED pads or monitor) allows for rapid defibrillation if needed.

NREMT material emphasizes early readiness for deterioration:

“Be prepared to manage sudden cardiac arrest in patients with chest pain.”

Why the other options are incorrect:

A. Sublingual nitroglycerin administration:EMTs may only assist with nitroglycerin if it is prescribed to the patient. This patient has no prescription medications, so nitroglycerin is contraindicated.

B. 12-lead acquisition and transmission:This is typically an ALS (paramedic-level) intervention, not standard EMT scope in NREMT context.

C. Applying supplemental oxygen:The patient’s SpO₂ is 95% on room air, which does not indicate hypoxia. NREMT guidelines recommend oxygen only if SpO₂ is low or patient is in respiratory distress.

NREMT guidance:

“Oxygen should be administered based on patient need, not routinely.”

Exact Extracts:

“Administer aspirin to patients with suspected cardiac chest pain.”

“Oxygen should be given only if the patient is hypoxic or shows signs of respiratory distress.”

“Be prepared for cardiac arrest in patients with suspected myocardial infarction.”