Reasons why paramedics do not administer aspirin to patients complaining of chest pain.The importance of aspirin therapy in patients with unstable angina un·sta·ble angina n. Angina pectoris characterized by pain of coronary origin that occurs in response to less exercise or other stimuli than usually required to produce pain. and myocardial infarction myocardial infarction: see under infarction. is well established. However, previous studies have shown low rates of administration of aspirin by paramedics. The purpose of this study was to determine the rate of aspirin administration in our Emergency Medical System (EMS) and to prospectively identify the reasons for not administering aspirin. We performed a retrospective chart review of chest pain EMS transports to determine the rate of documented aspirin administration. We then performed a prospective observational study In statistics, the goal of an observational study is to draw inferences about the possible effect of a treatment on subjects, where the assignment of subjects into a treated group versus a control group is outside the control of the investigator. . Setting was a university tertiary referral center and a community hospital. A medical student took a convenience sample of paramedics presenting with a patient complaining of chest pain. The paramedic par·a·med·ic n. A person who is trained to give emergency medical treatment or assist medical professionals. paramedic was asked if they gave the patient nitroglycerin nitroglycerin (nī'trōglĭs`ərĭn), C3H5N3O9, colorless, oily, highly explosive liquid. It is the nitric acid triester of glycerol and is more correctly called glycerol trinitrate. , aspirin, and/or oxygen. They were also asked about use of the cardiac monitor. If any one of the four items had not been done, the paramedic was queried for their reasoning. In the retrospective phase of the study, there were a total of 514 EMS runs reviewed. Aspirin was administered to 102 patients (19.8%). In the prospective study, there were a total of 46 transports by paramedics entered into the study. Only 13 (28.3%) of the patients had aspirin administered by the paramedic, and an additional 10 patients (21.7%) had already taken aspirin that day. Reasons for not administering aspirin to the remaining 23 patients were pain felt to be non-cardiac (13), patient no longer having chest pain (3), patient in congestive heart failure congestive heart failure, inability of the heart to expel sufficient blood to keep pace with the metabolic demands of the body. In the healthy individual the heart can tolerate large increases of workload for a considerable length of time. (2), paramedic forgot (2), other (3), Paramedics administer aspirin to only a small number of patients with chest pain. In most cases; however, the paramedic was following prescribed protocols or the patient had already taken aspirin. Only rarely did the paramedics actually forget to administer the aspirin. Edmond A. Hooker, MD, Tim Price, MD, and Taylor Benoit. University of Louisville See also
1. ^ [1] 2. ^ [2] URL accessed on June 8 2006 3. , Louisville, KY. |
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