The need-to-know information for Acetylsalicylic Acid (Aspirin):
Acetylsalicyclic AcidPearls and Fun Nuggets
1. Aspirin is a common, over-the-counter NSAID. Like other NSAIDS (ibuprofen, naproxen, etc.), it functions as an anti-inflammatory, antipyretic, and analgesic…but none of those things are particularly important for us 🚫. What makes it useful to us is it’s antiplatelet characteristics, particularly for our Chest Pain protocol.
2. As an antiplatelet, or “platelet aggregation inhibitor”, it works by keeping the platelets in the body slick. In other words, when platelets try to clump together to form, the aspirin will keep the platelets from sticking to each other. It’s like putting butter all over them 😁
3. There are only 3 protocols in which this drug is used: Chest Pain, DVT, and Pulmonary Embolism…in other words, the CLOT protocols! In each one of these, there is a risk for the body’s own platelets to clump to a clot, further exacerbating an already fragile situation. That’s where aspirin comes in. Each protocol calls for an early dose of 325mg PO 💊 as soon as one of these protocols is suspected.
4. Aspirin is NOT a “blood thinner”! Well, technically it is, but it’s not an anti-coagulant like Warfarin or Heparin. Anti-coagulants work by slowing down the entire clotting process through a blockage of vitamin-K dependent clotting factors, while anti-platelets work specifically on the platelets. In other words, anti-coagulants are “stronger” medications 💪. Why does this matter? Because although both types of medications can increase internal bleeding, you don’t need to be quite as worried about trauma patients if they take daily aspirin as opposed to daily Warfarin.
5. Aspirin allergies and sensitivities are fairly common in people 👬. Technically speaking, this can be a contraindication for the use of aspirin. However, this is where your clinical judgment comes in. If past reactions have been severe (ex. asthma attack or anaphylaxis), then it might be wise to hold off on using it. But never withhold a life-saving drug like Aspirin for someone who gets a “stuffy nose” when they take it.
Patient Perspectives
“My family has a history of heart attack so I always carry aspirin with me just in case. I found a wristband on the market that stores 2 aspirin in it. It is a great and convenient method of carrying aspirin around so I don’t need a bulky bottle of it in my pocket. It is called the Beatfirst Aspirin Wristband for anyone else with the same problem.”
“Pharmacist told me to take 2 aspirin (500mg) every four hours, my pain has been greatly relieved and my injuries are much better when it comes to pain. Aspirin is cheap and very useful.”
“Due to intestinal bleeding, I cannot take typical NSAIDs for heart attack preventative care. However, because of the ‘buffering’/magnesium in this product, I can, but in small doses. I cannot find 81 mg of Bufferin so I take a 326 mg tablet and quarter it, taking it in the evening, 98% of the time without a bleeding problem. When I have joint pain, I may double it but then bleeding can become a problem, again.”
References
- Why every medic should love Deployed Medicine - November 8, 2020
- 3 Areas Where Medics Fall Short - November 7, 2020