EMTs are authorized to administer a 325 mg aspirin tablet to patients with
signs of acute coronary syndrome
. There is no practical skills requirement for this course. CBT243 is an EMT continuing education course.
When should an EMT take aspirin?
4.1. According to the American Heart Association’s ACLS guidelines, aspirin should be given in the
immediate general treatment of “chest pain suggestive of ischemia”
.
When should you administer aspirin?
“Aspirin is helpful if
taken within the first 48 hours of an ischemic stroke
.” But the other 15 percent of strokes are hemorrhagic, caused by blood vessels bleeding into the brain. As a blood thinner, aspirin would increase bleeding and worsen a hemorrhagic stroke.
Does an EMT need permission to give aspirin?
As an EMT, you
may be authorized to administer aspirin
to a patient with chest pain based on: … the patient’s condition. B. your local EMS protocols.
How do you administer aspirin to a patient with chest pain?
Recommended dosage
The recommended dose of aspirin during a heart attack is
160 to 325 milligrams (mg)
. If you already take daily low-dose aspirin, take two tablets (162 mg). For the fastest results, you should crush or chew the tablet before swallowing it.
Can an EMT administer aspirin to a patient with chest pain?
Introduction: Aspirin is administered to patients with acute coronary syndromes (ACSs), but
prehospital providers do not administer aspirin to all patients with chest pain
that could be secondary to an ACS.
When should an EMT not take aspirin for chest pain?
Aspirin Precautions
You should avoid giving ASA to the following patients:
History of GI bleeding or other bleeding disorders
.
History of recent
(within 14 days) surgery. Allergy to ASA.
How do EMTs administer aspirin?
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.
When administering aspirin to a patient with an acute coronary syndrome you should?
All patients presenting with ACS should receive
nonenteric-coated chewable aspirin in a dose of at least 162 to 325 mg
, unless there is a clear history of aspirin allergy.
When Should aspirin not be administered?
Previous guidelines from the United States Preventive Services Task Force warned against taking aspirin for the primary prevention of heart disease unless you’re at an elevated risk — typically if you’re
50 to 69 years old with a 10 percent or greater chance of having a heart attack or stroke within the next 10 years
.
Can EMTs administer medications?
Certified EMTs
may perform all procedures and administer all medications contained
in the current 6000 Series WV EMS System Protocols. Medications authorized for administration by EMTs are: Activated Charcoal. Albuterol.
Can you give aspirin and nitro together?
The guideline recommends that the patient with
acute coronary syndrome should receive aspirin and a maximum of three doses of nitroglycerin, five minutes apart
. However, the current guidelines do not recognize the importance of the order in which these medications should be given [4, 5].
What are contraindications for aspirin?
Contraindications: Aspirin is contraindicated in
patients with known allergy to NSAIDs
and in patients with asthma, rhinitis, and nasal polyps. It may cause anaphylaxis, laryngeal edema, severe urticaria, angioedema, or bronchospasm (asthma).
How does aspirin help with pain?
Aspirin works to
reduce
this pain and swelling because it is an analgesic (pain reliever), an antipyretic (fever reducer) and an anti-inflammatory (fights swelling and inflammation). In addition to chemically blocking your body’s pain signals, aspirin can also reduce the risk of heart attacks and certain strokes.
What role does aspirin play in ACS?
Aspirin in Acute Coronary Syndrome
1: Aspirin
acts to inhibit the activity of the cyclooxygenase enzyme
and thus attenuates the production of prostaglandins and thromboxane. 2: The ADP receptor antagonists bind to the P2Y
12
receptor to prevent ADP-induced platelet activation.
What are the nursing implications for aspirin?
Nursing considerations
–
Assess pain and/or pyrexia one hour before or after medication
. – In long-term therapy monitor renal and liver function and ototoxicity. – Assess other medication for possible interactions – especially warfarin which is a special hazard.
What does EMT do for chest pain?
The most common range for prehospital fluid boluses is between 250-500 cc. Once the blood pressure was stable (>100 mmHg systolic), the crew began to treat the chest pain with
nitroglycerin
. Nitroglycerin is a medication that dilates the blood vessels; it works rapidly when administered sublingually (under the tongue).
Why is aspirin and clopidogrel given together?
The combination of clopidogrel and aspirin
may lower the risk for major ischemic events among patients
with minor ischemic stroke or high-risk transient ischemic attack compared with aspirin alone, according to results of the POINT study.
What is the appropriate route for nitroglycerin administration by the EMT?
To administer
a sublingual (SL)
medication, place the pill or direct the spray between the underside of the tongue and the floor of the oral cavity. The medication is rapidly absorbed through the mucous membranes of the mouth and blood vessels of the tongue. The most common drug given by this route is nitroglycerin.
How is nitroglycerin usually given by the EMT?
Sublingual nitroglycerin is typically
administered one tablet or spray every five minutes up to three doses
. Some prehospital protocols recommend continuing dosage and even administering higher dose nitroglycerin two to three sublingual doses together in cases of hypertensive congestive heart failure.
What are the interactions of aspirin?
Some products that may interact with this drug include:
mifepristone
, acetazolamide, “blood thinners” (such as warfarin, heparin), corticosteroids (such as prednisone), dichlorphenamide, methotrexate, valproic acid, herbal medications (such as ginkgo biloba).
What is an adverse reaction to aspirin?
Aspirin can cause allergic reactions in some people. Symptoms include
flushing, itchy rashes (hives)
, blocked and runny nose and asthma (sometimes severe), usually within an hour of taking a tablet.
Can hypertensive patients take aspirin?
High blood pressure (hypertension) is a risk factor for heart disease—and for years, a
low dose of daily aspirin has been considered a safe and healthy way
to prevent heart disease. It’s reasonable, therefore, to associate aspirin with lowering blood pressure, as a key way of preventing heart attacks and strokes.
Can EMTs give pain meds?
KQ2c: EMS personnel that administer or handle analgesics in the care of patients with acute onset, non-traumatic, moderate to severe pain. EMS personnel who administer or handle analgesics include emergency medical technicians, advanced emergency medical technicians, and paramedics.
What pain relief can paramedics give?
- Nitroglycerin (coronary vasodilator for chest pain).
- Morphine (narcotic/opioid).
- Fentanyl (synthetic opioid).
- Dilaudid (hydromorphone) (synthetic opioid).
- Toradol (ketorolac) (anti-inflammatory).
- Nitronox (nitrous oxide) (gas analgesic).
What medications can an advanced EMT administer?
The EMT-Enhanced can start IV lines, perform dual-lumen airway insertion, and administer some medications such as
D50W, glucagon, albuterol, epinephrine, and sometimes narcotics
. They cannot, however, administer any cardiac medications.
What medication should not be given with nitroglycerin?
- Sildenafil, tadalafil, vardenafil, and avanafil. Taking any of these drugs with nitroglycerin can cause very low blood pressure.
- Ergotamine. Taking these drugs together can cause more chest pain.
- Riociguat. Taking these drugs together can cause very low blood pressure.
Do you give aspirin or nitroglycerin first?
Aspirin helps keep your blood from clotting. When taken during a heart attack, it could reduce heart damage. Don’t take aspirin if you are allergic to it or have been told by your doctor never to take aspirin.
Take nitroglycerin, if prescribed
.
When is nitroglycerin contraindicated?
Nitroglycerin is contraindicated in patients that
have reported allergic symptoms to the medication
. [18] Known history of increased intracranial pressure, severe anemia, right-sided myocardial infarction, or hypersensitivity to nitroglycerin are contraindications to nitroglycerin therapy.
