Acetylsalicylic Acid (Aspirin, ASA)

Question 1

General

Answer 1

• Platelet inhibitor & antithrombotic medication
• Given to PTs w/ cardiac chest pain during Primary Survey
• Considered a critical intervention
• ONLY medication EMR may administer without baseline set of vitals

Question 2

Classification

Answer 2

Platelet inhibitor/anti-inflammatory

Question 3

Action

Answer 3

Blocks platelet aggregation & vasoconstriction

Question 4

Indications

Answer 4

Chest pain or atypical symptoms suggestive of cardiac ischemia & myocardial infarction

Question 5

Contraindications - Functional inquiry

Answer 5

1. Asthma Exacerbation
   - Ask PT if their asthma has ever been exacerbated by taking NSAIDS (e.g. ibuprofen, Naproxen)
2. Allergy / Hypersensitivity
   - Ask PT if they have a hypersensitivity to Aspirin or other NSAIDS
3. Pediatric
   - Pediatric w/ viral illness contraindicated
   - Chest pain in children is unlikely to be ischemic in nature, as such ASA contraindicated unless rare specific ischemic cardiac history
4. Dose
   - PT may not exceed 162mg w/in a 12 hr period
5. Acute Bleed
   - Lood for any signs or symptoms of an acute bleed including signs & symptoms of CVA or history of recent head trauma (brain bleed)

Question 6

Contraindications - Physical Assessment

Answer 6

None

Question 7

Cautions - Functional Inquiry

Answer 7

1. Pregnancy
   - Ask PT about possibility of pregnancy
2. Recent internal bleeding
   - Ask abt blood in vomit/stool (GI bleed)
3. Bleeding Disorders
   - Review history
4. Anticoagulants
   - Review meds for PT currently taking anticoagulants
5. Surgery
   - Ask abt recent major surgery (heart, vascular, abdominal, angioplasty/angiograms)

Question 8

Cautions - Physical Assessment

Answer 8

1. Recent Internal Bleeding
   - Assess for S&S of internal hemorrhaging (Blood in vomit/stool, S&S of shock, rigid abdomen, bruising around navel/flank)
   - Assess for head injuries
   - S&S of stroke
   - S&S of intracranial pressure (increased BP, irregular breathing & bradycardia, unequal pupils DLOC)
2. Surgery
   - Assess for scars indicating recent surgery

Question 9

Side effects

Answer 9

• Respiratory: wheezing
• GI: Heartburn, nausea & vomiting
• ASA has been linked to Reye’s syndrome in children w/ viral symptoms

Question 10

Dosage

Answer 10

160-162 mg in a 12 hr period

Question 11

Routes

Answer 11

PO

Question 12

Onset, Duration

Answer 12

• Onset: 1 hr or 20 mins if chewed
• Peak: 1-2 hrs
• Duration: 4-6 hrs; platelet inhibitory effects last lifetime of platelet
• Half Life: 3hrs (low dose)