Don’t lie about Viagra use

And don’t self abuse yourself into a 450 lb blob and expect some type of miracle rescue when you fall into the medical pit.

“They gave him an aspirin, and after he denied using Viagra, a nitroglycerin sublingual. Immediately thereafter his blood pressure dropped from 150s systolic to low 80s. “

Thing is, if you are asking the patient a question to which you know they might be reluctant to divulge the complete truth, then you have an obligation to include the risks of their non-disclosure in your informed consent. The ambulance crew knew the implication of viagra/nitrates interaction, but the patient did not. It need not be very complicated but the patient must be appraised of the potential outcomes of their actions. Something like “I am going to give you nitroglycerine, which might help your chest pain and save your life. However, if you have taken viagra today then giving you nitroglycerine will kill you. Do you think you might have taken any viagra?, because if you don’t tell us, you will die.”