A 64-year-old patient expresses feelings of impending doom with chest pain despite nitroglycerin and oxygen. What should you do next?

In this scenario, the patient’s expression of impending doom combined with chest pain indicates a potentially critical condition, such as a myocardial infarction (heart attack) or other serious cardiac event. When a patient exhibits these symptoms, especially after receiving nitroglycerin and oxygen without relief, it is essential to prioritize rapid transport to a medical facility.

Immediate transport is crucial because time-sensitive interventions are often required in cases of significant cardiac issues. While monitoring vital signs, providing reassurance, and administering additional nitroglycerin may be important steps in patient management, they are secondary to ensuring the patient receives definitive care at a hospital. Delaying transport could lead to a deterioration in the patient’s condition.

In this context, recognizing the gravity of the situation and acting swiftly by transporting the patient to a facility where they can receive advanced cardiac care is the most appropriate next step.