Comments on: Aspirin http://medicscribe.com/2010/03/aspirin/ Peter Canning's EMS Journal Fri, 03 Feb 2012 20:19:06 +0000 hourly 1 http://wordpress.org/?v=3.3.1 By: The Essential Eight | Street Watch: Notes of a Paramedic http://medicscribe.com/2010/03/aspirin/comment-page-1/#comment-9256 The Essential Eight | Street Watch: Notes of a Paramedic Mon, 15 Mar 2010 16:56:33 +0000 http://medicscribe.com/?p=3446#comment-9256 [...] Narcan 10. Aspirin 11. Amiodarone 12. Atropine 13. Dopamine 14. Zofran 15. Cardizem 16. Adenosine 17. Glucagon 18. [...] [...] Narcan 10. Aspirin 11. Amiodarone 12. Atropine 13. Dopamine 14. Zofran 15. Cardizem 16. Adenosine 17. Glucagon 18. [...]

]]> By: totwtytr http://medicscribe.com/2010/03/aspirin/comment-page-1/#comment-9251 totwtytr Mon, 15 Mar 2010 09:24:49 +0000 http://medicscribe.com/?p=3446#comment-9251 Although ASA has proven benefit in MI patient, like all medications, it has risks. Our triage cards direct 9-1-1 operators to instruct patients to take 325mg of ASA if the caller gives information that indicates ACS. I think that's a mistake since so many times triage is wrong. In effect, they are blindly directing the patient to take a medication that not only might not help, but might hurt. Our BLS crews can give it, but again, I'm not so sure that it is that beneficial vs the potential harm. I don't think that the 10 or so minutes delay until an ALS unit arrives and can do a more thorough evaluation and 12 lead EKG is going to be that harmful. Something to discuss with the medical director next time we chat. Although ASA has proven benefit in MI patient, like all medications, it has risks. Our triage cards direct 9-1-1 operators to instruct patients to take 325mg of ASA if the caller gives information that indicates ACS. I think that’s a mistake since so many times triage is wrong. In effect, they are blindly directing the patient to take a medication that not only might not help, but might hurt. Our BLS crews can give it, but again, I’m not so sure that it is that beneficial vs the potential harm. I don’t think that the 10 or so minutes delay until an ALS unit arrives and can do a more thorough evaluation and 12 lead EKG is going to be that harmful.

Something to discuss with the medical director next time we chat.

]]> By: medicechic http://medicscribe.com/2010/03/aspirin/comment-page-1/#comment-9239 medicechic Fri, 12 Mar 2010 16:03:30 +0000 http://medicscribe.com/?p=3446#comment-9239 I've read that about broncospasm in asthmatics too, although it didn't include the nasal polyps. Protocols and standing orders definitely don't cover every situation. For example, our protocol states contraindications for ASA as allergy or GI bleed. Personally I can't take it due to a clotting disorder. I had a chronic renal failure patient a few days ago that I let the doc make the choice. She chose NTG and morphine (reduced dose due to CRF). ASA is excreted through the kidneys. Why would I give a medication to someone that can't get it out of their system unless it is absolutely necessary? In the past I've deferred it to the hospital when the pt had recent surgery, trauma, etc. Just because protocol says A is happening do B doesn't necessarily mean you need to do it. We're not puppets, this is why many protocols include the word consider and we are taught to think for ourselves and if in doubt call medical control. I’ve read that about broncospasm in asthmatics too, although it didn’t include the nasal polyps.
Protocols and standing orders definitely don’t cover every situation. For example, our protocol states contraindications for ASA as allergy or GI bleed. Personally I can’t take it due to a clotting disorder. I had a chronic renal failure patient a few days ago that I let the doc make the choice. She chose NTG and morphine (reduced dose due to CRF). ASA is excreted through the kidneys. Why would I give a medication to someone that can’t get it out of their system unless it is absolutely necessary? In the past I’ve deferred it to the hospital when the pt had recent surgery, trauma, etc. Just because protocol says A is happening do B doesn’t necessarily mean you need to do it. We’re not puppets, this is why many protocols include the word consider and we are taught to think for ourselves and if in doubt call medical control.

]]> By: Ambulance Driver http://medicscribe.com/2010/03/aspirin/comment-page-1/#comment-9238 Ambulance Driver Fri, 12 Mar 2010 13:59:26 +0000 http://medicscribe.com/?p=3446#comment-9238 Supposedly can precipitate bronchospasm in asthma patients with nasal polyps. Never seen it, though. Supposedly can precipitate bronchospasm in asthma patients with nasal polyps.

Never seen it, though.

]]>