1. Why give aspirin to someone with ACS?

The main effect of early aspirin administration is its anti-inflammatory properties. This helps protect inflamed heart muscle that may be in jeopardy from ischemia.

Aspirin also reduces the body's production of prostaglandins. Prostaglandins can cause platelets in the blood to stick together. This can lead to blocked blood vessels and prevent delivery of oxygen-rich blood to the tissues. Reducing the prostaglandins may reduce the risk of dangerous blood clots, heart attacks and strokes. The anti-platelet effect takes an hour to “kick in.”

2. What if the patient is not alert?

Administer aspirin only if a patient is fully alert. 

3. What if the patient has his own nitro prescription?

If a patient has his or her own nitroglycerin and meets the criteria for administration of nitro, do not delay in assisting with nitro. Administer the nitro using local protocol, then give aspirin.

4. What if patient has taken other medications such as ibuprofen (Advil) or acetaminophen (Tylenol) in the last few hours?

You should still give an aspirin.

5. What if the patient takes daily aspirin?

You should give an aspirin unless the aspirin was taken in the last couple of hours. The patient may be taking a dose (81 mg) that is not strong enough for an anti-inflammatory response (though it will cause an anti-platelet response). Therefore a full strength aspirin is indicated.