Administration of Aspirin

Transcription

1 Administration of Aspirin Indications and Use for the NH EMT-Basic and Intermediate New Hampshire Division of Fire Standards & Training and Emergency Medical Services

2 Acute Coronary Syndrome This is an umbrella term used to cover any group of clinical symptoms compatible with acute myocardial ischemia The chest pain protocol in The NH Patient Care Protocols is Acute Coronary Syndrome

3 Signs and Symptoms Chest pain Difficulty breathing Nausea/Vomiting Radiating pain to neck, back, shoulder, jaw, or arms Loss of consciousness, irregular heart rhythms

4 Treatment Scene safety and BSI Oxygen high flow or assist ventilation as needed Vital signs Limit the patient s activity Call for ALS Assist with nitroglycerin if indicated Cardiac monitor Aspirin administration (new)

5 Aspirin It is important to administer aspirin in the pre-hospital setting because the action of aspirin, when given in the event of AMI, has shown to decrease mortality.

6 What is Aspirin (ASA) For more than 100 years, aspirin has been used as a pain reliever for headaches and other minor aches and pains. More recently, aspirin has been widely studied in terms of both preventing cardiovascular disease and in managing the conditions of people who already have heart disease or a history of heart attack, by inhibiting clot formation. According to the United States Food and Drug Administration (FDA), Americans consume over 20 billion tablets a year.

7 How does aspirin work? Chemically, aspirin is known as the compound acetylsalicylic acid (ASA). It fights pain and inflammation by blocking the enzyme called cyclooxygenase, or COX. When this enzyme is blocked, the body is less able to produce prostaglandin, which is a chemical that signals an injury and triggers pain.

8 Prostaglandin Aspirin does not heal the underlying problem causing the pain (i.e., the wound itself), but it can help reduce the number of pain messengers traveling through the nerves to the brain. Prostaglandin also causes platelets to bind together, causing clots.

9 How does aspirin prevent blood clots? If prostaglandin production is slowed or inhibited, so too is clot formation. Therefore, aspirin belongs to a group of drugs called antiplatelets.

10 Aspirin in cardiac emergencies Aspirin therapy in heart attack patients significantly reduces the risk of damage from the ongoing attack, as well as the overall risk of having another one. Chewing the tablet, rather than swallowing it whole, helps release the medication into the bloodstream faster. Men are more likely than women to take or to be given aspirin. Patients over 80 are less likely than others to be prescribed aspirin as a preventive medicine.

11 Indications of ASA Administration Chest pain that is consistent with the possibility of a heart attack and/or acute myocardial infarction Unstable angina and AMI Non-traumatic chest pain not relieved by nitroglycerin or lasting > 15 minutes

12 Side Effects of Aspirin Administration Stomach upset, which could in time lead to ulcers, pain, heartburn, nausea, vomiting, internal bleeding or holes in the stomach or intestines Stomach damage, possibly indicated by bloody, black or tarry stools or by bloody vomit Facial swelling (usually indicates an allergy) Asthma attack (another indicator of allergy) Ringing in the ears (when taken in high doses) Risk of bleeding in the brain, a medical emergency that could lead to stroke

13 Contraindications of Aspirin Administration Known hypersensitivity to the drug or allergy Unresponsive pt. Unable to swallow Asthma, liver disease, severe bleeding Receiving anti clotting therapy Possible aortic dissection

14 Precautions to Aspirin Administration Use with caution in patients with renal failure or vitamin K deficiency

15 Dose and Route of Aspirin Administration 324 mg (4 chewable children s aspirin) by mouth