Background:  Nitroglycerin (NTG) is a direct dilator of veins and arteries. Its action is to relax vascular smooth muscle and increase blood flow by causing vasodilation.  In patients diagnosed with coronary artery disease, NTG Ointment has been utilized as a method to provide sustained absorption to prophylactically prevent angina, and increase exercise tolerance.  Current practice at our facility is inconsistent. Various physicians prescribe the use of plastic wrap in place of the manufacturer supplied applicator paper.

Purpose:  To investigate NTG ointment's vasodilatory effectiveness in decreasing systolic blood pressure based on application method. 

Design:  Quasi-experimental design. 

Sample:  This study will enroll subjects that have been admitted to the Medical Telemetry unit using a convenience sample.  Subjects will be patients admitted with a diagnosis of Acute Coronary Syndrome.  Randomization to an experimental group using plastic wrap to cover the applied NTG ointment, or a control group using the manufacturer provided applicator paper to cover the applied ointment.

Methods:  Institutional Review Board approval has been applied for. Subjects will have their blood pressure measured prior to the application of the NTG ointment, and in one hour following the application. All blood pressures will be taken on the right or left upper arm, and the same arm used consistently for measurement.  Those patients randomized into the experimental group will have one inch of NTG ointment smoothed onto the skin 3 ½ x 2” followed by plastic wrap. The control group will use applicator paper in place of plastic wrap.  In addition to blood pressure, other variables for data collection will include headache discomfort and dizziness.   

Results and Discussion:  The data collection is in process. If there is a difference, patients and nursing staff can benefit from the outcome by using a consistent method for applying NTG ointment.