Pre-Arrivial Instructions

[Jon]

So the topic came up in another thread:

does your service/dispatch center provide pre-arrival instructions for your patients that include ASA for Chest Pain patients?

 

[reaper]

My current service does prearrival instructions, but not ASA. Old service did ASA prearrival and had good results with it.

 

[vquintessence]

Nothing other than CPR. They cite liability to giving "medical instructions" to the lay person.

 

[marineman]

We don't again due to liability and the fact that we can't give them any more if they've already taken ASA and theirs could be out of date or defunct for some other reason which would do us no good at all.

The pre arrival instructions they have are essentially basic first aid techniques such as CPR, put pressure where the red stuff is coming from etc. Prescribing medications is beyond the scope of a dispatcher.

 

[Juxel]

Another question to build on the first: If you arrive on scene and the patient has taken ASA already, do you still give it or do you skip it?

Per protocol we have to give it unless the patient states they chewed it (nobody does) and we check the expiration date on the container.

 

[vquintessence]

Another question to build on the first: If you arrive on scene and the patient has taken ASA already, do you still give it or do you skip it?

Per protocol we have to give it unless the patient states they chewed it (nobody does) and we check the expiration date on the container.

Immediately prior to arrival? No, probably wouldn't administer more.
If you mean taken ASA as part of their daily regiment? I'd still give em the 324 mg. There are differing opinions, so far nobody (myself included) has shown me any evidence of whether or not this is harmful or even beneficial. Anybody have any insights?

 

[ruffems]

our dispatch system does not do pre-arrival. They would not have done any good for my father in law last week as his son was already doing CPR on him.

But pre-arrival ASA and the like would be good at times.

 

[TomB]

I don't know if our dispatchers advise chest pain patients to take aspirin or not, but it's an evidence based strategy that is encouraged by the ACC/AHA guidelines. If it's in their protocols which are approved by your EMS system's Medical Control Physician, then it's not "prescribing medicine" so don't worry about that. The dose should not be repeated if the patient has already taken a 325 mg tablet, simply on the basis that it wasn't chewed.