by New York State

Emergency Medical Technicians

The New York State Emergency Medical Advisory Committee (SEMAC) and the NYS EMS Council (SEMSCo) have approved the EMT-B to administer aspirin (ASA) to those patients who are classified as cardiac related patients.

The American Heart Association 2005 Guidelines have stated that prehospital providers should administer aspirin to those patients who may be suffering from an acute coronary syndrome.

The NYS EMT-B Original Curriculum has been updated to reflect the change as well. In particular module 4-3 Cardiac Emergencies has been updated. The updated curriculum is available from the DOH web site at: http://www.nyhealth.gov/nysdoh/ems/pdf/emtoriginalmod4.pdf

Indications

Unstable angina

Acute Myocardial Infarction/Acute Coronary Syndrome

Non-traumatic chest pain/discomfort not relieved by nitroglycerin or lasting >15 minutes

Contraindications

Patient is unable to chew or swallow, including GCS >15

Allergy to aspirin, products containing aspirin, or aspirin-like products

History of active bleeding disorder

Recent or current ulcer or gastrointestinal bleeding

Taken aspirin within the last 24 hours

Patient prescribed anticoagulation therapy

Possible aortic aneurysm

Medication Form: Tablet, Nonenteric chewable

Doage: 160mg - 325mg (2-4 chewable children's aspirin tablets) chewed by mouth

Southern Tier dosage is 324 mg.Check your regional protocols!

Administration

Perform focused assessment for cardiac patient.

Begin transport (aspirin may be administered prior to initiation of transport as long as this does not delay transport)

Determine there are no contraindications for aspirin administration.

Assure medication is not expired or in an unusable condition.

Explain procedure to patient including that they will need to chew and not swallow the aspirin.

Assure correct dosage of 160 325 mg. Check your regional protocols!

Allow patient to self administer the aspirin if they are able to do so. If they are not able to self administer, assure BSI precautions and place the tablets in the patient's mouth.

Instruct patient to chew the tablets until they are dissolved.

Do not give fluids by mouth.

Record activity and time.

Perform reassessment.

Side Effects

Gastrointestinal distress.

May increase the severity of bleeding or bleeding disorders.

Gastrointestinal bleeding.

Low-grade toxicity may cause ringing in the ears, headache, dizziness, flushing, tachycardia.

Reassessment Strategies

Monitor patient's vital signs

Record reasssessments on prehospital care report