In our continued commitment to uphold standards of professional practice and education with all members of emergency medicine and emergency medical services, the National Association of Emergency Medical Technicians (NAEMT) has created the following position on emergency aspirin administration for suspected heart attack.
To determine the standard protocol of administering aspirin to cardiac patients in an emergency setting, members of NAEMT were invited to participate in an online, scientific Harris Interactive survey in July 2005. Findings indicated that more than four in five NAEMT members (84 percent) administer aspirin to a conscious patient at the onset of a suspected heart attack. More than four in five NAEMT members (82 percent) stock their emergency vehicles with chewable aspirin. But despite standard procedure of having conscious MI patients chew aspirin, only about one-third of NAEMT members (34 percent) are aware that the FDA has guidelines on the use and proper dosage of aspirin for patients suffering a suspected heart attack.
The U.S. Food & Drug Administration (FDA) has published guidelines surrounding the dosage and administration of aspirin during a suspected acute myocardial infarction and in patients with chest pain or other symptoms considered from acute coronary syndromes. The FDA stated that for cases of suspected MI, “an initial dose of at least 160 to 162.5 mg is administered.” This recommendation came on the heels of several studies that proved the life-saving benefits of aspirin since the very first randomized trial on the emergency use of aspirin in 1974. Nearly fifteen years later in 1988, the Second International Study of Infarct Survival Group (ISIS) concluded that giving aspirin to patients within the first 24 hours of an MI resulted in a 23 percent mortality reduction.
Based on the FDA’s recommendations, compelling field research and scientific findings, NAEMT strongly recommends that EMS personnel, in accordance with local protocols, administer at least 162 mg of chewable aspirin to patients suspected of acute MI. It is important that all first responders have immediate access to the proper dosage and form of aspirin for use in a cardiac emergency.
Position adopted September 23, 2005