EMTs (in King County) are authorized to administer one 325 mg aspirin tablet, or four 81 mg tables, for patients with acute coronary syndrome.
 
Administer aspirin to patients with signs or symptoms of ACS:

• Uncomfortable pressure, fullness, squeezing or pain in the center of the chest that lasts more than a few minutes or goes away and comes back
• Pain that spreads to the shoulders, neck or arms
• Chest discomfort with lightheadedness, fainting, sweating, nausea or shortness of breath

Contraindications for use of aspirin:

• Allergy to aspirin
• A 325 mg aspirin was taken for this event (within the last two hours)
• Systolic blood pressure in both arms is different by more than 15mm Hg

Steps in administering aspirin:

1. Be sure the patient is alert and responsive.
2. Check blood pressure in both arms.
3. Ask the patient to swallow a single, uncoated 325 mg aspirin tablet or four 81 mg tablets.
4. Do not delay in assisting with nitro if the patient has a prescription and meets criteria.
5. Request a paramedic response.
6. Record the dosage and the time of administration.