Are All Aspirin Created Equal?

“I took an Aspirin when I started feeling the pain.”

Close to a decade after the Aspirin for chest pain idea hit the main-stream, more and more folks are medicated themselves at the onset of chest pain. But are all Aspirin created equal? Does chewing make any difference in the rate of absorption?

No … and yes.

A recent study out of the University of California, San Diego took 14 healthy volunteers and feed them a moderate dose of Aspirin on three separate occasions. First they were asked to swallow adult size tablets, then they were asked to chew adult sized tablets and last they were asked to chew children’s chewable Aspirin tablets. After each administration the volunteers had blood drawn at set intervals. The results were predictable, but telling. After swallowing the adult tablets, 6 of the 14 volunteers had no detectable levelsof Aspirin in their system 45 minutes post swallow.

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Chest Pain: Is EMS Really Best?

Short answer: Yes.

Score one for EMS. A study published last January in the American Heart Journal evaluated transport and treatment times of patients who called 911 for their chest pain and patients who sought private transportation.

They found that patients who transported themselves to the emergency room arrived at the hospital in 35 minutes while patients who called 911 arrived in 39 minutes. (On average.)

Hold the phone. Before you tell grampa to forget the phone call and jump in the car, consider this; The study also concluded that the patients who dialed 911 received initial stabilizing treatments faster AND definitive treatments faster as well.

Those who called the ambulance received initial care like oxygen, aspirin and nitro in approximately six minutes as opposed to the self transporters who took 32 minutes to receive these interventions.

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Atypical Cardiac Chest Pain

We taught you what cardiac chest pain looked like, right? You remember.

We painted the perfect picture for you in your cardiac emergencies lecture in your EMT class. The pain felt like a pressure. It was brought on by exertion. It radiated to the left arm and through to the back. Sometimes, in your EMT skills stations, we would get fancy and have it begin at rest and radiate to the jaw. Just trying to keep you on your toes after all.

All this stuff is good to know. But we may have done you a disservice. You may be walking around with the idea that you can do a quick OPQRST and a SAMPLE and walk away with a fairly good feel for whether or not your patient is having a heart attack. You may be dead wrong.

What we may not have told you was that a large percentage of your patients suffering acute myocardial infarction won’t look anything like this. Atypical cardiac chest pain, those folks who have heart attacks but don’t quite feel like they’re supposed to feel, are actually very common. Common enough that we may need to think of a new name for them. Research says that the atypical folks may be a whole lot more typical than we think.

Did you know that the patient who is having a true myocardial infarction is 10% more likely to have pain radiate to his right arm than his left? Wrap your brain around that one.

It gets worse:

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