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Emt aspirin protocol update

New York State Department of Health Emergency Medical Technician - Basic Curriculum Aspirin Administration by
Emergency Medical Technicians
HISTORY

The New York State Emergency Medial Advisory Committee and the New York State
Department of Health have approved Emergency Medical Technician – Basics (EMT-B) to
administer aspirin to those patients who are classified as “cardiac related” patients.
The American Heart Association 2005 Guidelines have stated that prehospital providers should
administer aspirin to those patients who may be suffering from an acute coronary syndrome.
CHANGES
The New York State EMT-B Basic Life Support Protocols have been updated to reflect this
change. In particular the “Adult Cardiac Related Problem” protocol, M-5 has been updated and is
available from our web site.
The NYS EMT-B Original Curriculum has been updated to reflect the change as well. In
particular module 4-3 “Cardiac Emergencies” has been updated. The updated curriculum is
available from out web site at: http://www.health.state.ny.us/nysdoh/ems/basic.htm.

IMPLEMENTATION

Course Sponsors – The use of the updated EMT-B module 4-3 will start immediately
upon receipt of the updated module and training of instructor staff has been completed.
This training will occur in all original certification courses as well as all recertification
courses.

Agencies
– It is strongly encouraged by the Bureau of EMS that a NYS Certified
Instructor Coordinator or Certified Lab Instructor complete the in-service training of all
NYS certified personnel at the EMT-B level and above. If a CIC or CLI is not available,
the agency training officer can conduct the training with approval from the agencies
Medical Director.
When an agency conducts this in-service training there must be documentation kept on-
file at the agency. This documentation must include, but not limited to:
• Sign-in and sign-out attendance records. • Copies of all educational materials used for the purpose of this • Copies of all evaluation tools used for each provider who completed the training. Evaluation tools must be approved by the agency Medical Director before they are used. Training – The updated NYS EMT-B curriculum module, NYS BLS Protocol and a
practical skills evaluation form have been provided for your convenience and to assure
uniformity in training across the state. Please assure that all copies of the EMT-B
curriculum and protocol are replaced with these updated versions. Once a provider has
received this training they must be evaluated for both written and skill comprehension.
Training should include all objectives from EMT-B module 4-3. This will include an
overall review of unchanged objectives/content and a complete thorough instruction of
the new objectives/content.
NEW YORK STATE DEPARTMENT OF HEALTH
Practical
Bureau of Emergency Medical Services
Evaluation
ASPIRIN ADMINISTRATION
INSTRUCTIONS TO THE STUDENT/INSTRUCTOR
This station is designed to test the student’s ability to manage a prehospital patient complaining of chest pain who requires administration of aspirin. As you arrive on the scene, you encounter a patient who is complaining of chest pain/discomfort. You have completed your initial assessment as well as obtained a complete set of vital signs. You may use any of the supplies available in this room. You have 3 minutes to complete this skill station. Do you have any questions? Bureau of Emergency Medical Services
Practical Skills Evaluation – Emergency Medical Technician - Basic
Emergency Medical Technician - Basic
NEW YORK STATE DEPARTMENT OF HEALTH
Bureau of Emergency Medical Services
Skill Assessment
Administration
Comments
Verbalizes indications and contraindications for use of aspirin
Takes or verbalizes, body substance isolation precautions
Properly explains to patient the need for the medication and obtains patient’s States the correct milligrams per tablet States correct dosage for patient
Verifies patient will be able to safely ingest the medication Explains medication administration procedure to the patient Gives medication to patient and instructs patient to chew the medication Re-assess patient for any changes & assures no immediate adverse reactions Verbalizes documentation procedure including time of administration Candidate completed station within 3 minute time limit
Note: Candidate must complete all critical criteria and
receive at least 6 points to pass this station.
Total to pass: 6
COMMENTS:

Bureau of Emergency Medical Services
Practical Skills Evaluation – Emergency Medical Technician - Basic
Adult Cardiac Related Problem
Request Advanced Life Support if available.
Do not delay transport to the appropriate hospital.
Be prepared to deal with respiratory and/or cardiac arrest!
Assure that the patient’s airway is open and that breathing and circulation are adequate. Place the patient in a position of comfort, while reassuring the patient and loosening tight or restrictive clothing. Ongoing assessment. Obtain and record the patient’s vital signs, repeat enroute as often as the situation indicates. If patient has not taken aspirin and has no history of aspirin allergy and no evidence of recent gastrointestinal bleeding, administer nonenteric chewable aspirin (160 to 325 mg). VII. If chest pain is present and if the patient possesses nitroglycerin prescribed
by his/her physician and has a systolic blood pressure of 120mm Hg or
greater
, the EMT-B may assist the patient in self-administration of the patient’s
prescribed sublingual nitroglycerin as indicated on the medicine container.
A. In the absence of standing orders for nitroglycerin, contact medical control for authorization to administer the nitroglycerin. B. Confirm the systolic blood pressure is 120mm Hg or greater. C. Question patient on last dose administration of nitroglycerin, effects, and assure understanding of route and administration. D. Administer one (1) metered dose of nitroglycerin spray or one (1)
nitroglycerin tablet under the patient’s tongue without swallowing and record the time of the administration. NYS EMT-B Basic Life Support Protocols UPDATED 1/18/07 M – 5 Page
E. Recheck blood pressure within two (2) minutes of administration and record any changes in the patient’s condition. Record all patient care information, including the patient’s medical history and all treatment provided, on a Prehospital Care Report (PCR). NYS EMT-B Basic Life Support Protocols UPDATED 1/18/07 M – 5 Page
Adult Cardiac Related Problem, continued
NYS EMT-B Basic Life Support Protocols UPDATED 1/18/07 M – 5

Source: http://gatesems.org/uploads/File/aspirin_administration_2007-01.pdf

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