Aspirin - To give or not to give?
FACT was concerned about the recent information released in the last HSE newsletter regarding the administration of aspirin. We felt that it was not clear enough in just what we should be teaching in the first aid management of a suspected heart attack (specifically for occupational first aid). Are we to give aspirin or not?
The HSE newsletter stated:
"Aspirin administration
Anecdotal information has come to our attention that training on the administration of aspirin on FAW courses appears to be inconsistent. The view of HSE is that the administration of medication by a first aider is not part of a FAW or EFAW training course, but you can assist an individual in taking it. However, the one exception is when training students on first aid for heart attacks, when this subject must be covered. Therefore, for heart attack management, the student must be able to assist a casualty in taking 300 mg of aspirin and to advise them to chew it, not swallow."
We sent HSE a letter asking for clarification on this matter.
Dear Sir,
We write with reference to your last FAW newsletter (February 2011) and in particular the article on Aspirin administration. Your article states that you have received anecdotal information about training information relating to the administration of Aspirin being inconsistent. We by no means wish to appear rude but we feel that your article re Aspirin can only compound this apparent confusion.
What is the article trying to say? Are we to teach that those individuals suffering from the signs and symptoms of a heart attack should be given aspirin? And if yes, does this mean that it has to be the individuals own aspirin or can the aspirin be obtained by other means? Should First Aid boxes now contain aspirin?
It would be advantageous to know the boundaries relating to this highly contentious subject i.e. what contra-indications should we be teaching? It is also important to remember that Ambulance Service control operators are issuing instructions to callers to administer 300mg of Aspirin during the 999 call.
We look forward to your response.
Yours faithfully
We are pleased to inform you of the response to our letter to the HSE regarding the teaching of the administration of aspirin to a suspected heart attack victim. We are happy to be able to offer you the following advice:
The teaching of assisting a casualty to take an aspirin (300mg) whom you believe might be suffering a heart attack should be encouraged, regardless of the casualty being at work.
This is in accordance with the voluntary Aid Societies (VAS) manuals as well as others including the First Aid made Easy books by Nigel Barraclough.
It should be emphasised that the dose should be 300mg and the aspirin should be chewed, when the casualty is handed over to the ambulance service or other appropriate health care professional they should be given that information at the time of handover. This should also be noted in any appropriate or relevant report following the incident.
The issue of contra indications of aspirin should not be worried about when teaching this subject, as one dose is considered to have more beneficial effects than potential side effects. It should though be emphasised that if a casualty does not consent to taking the aspirin for whatever reason then that should be respected and noted. HSE do also state that employers should consider the issue of the availability of aspirin and its storage within the workplace for the treatment of suspected heart attack, and any insurance implications this might bring. This should be considered within the workplace first aid risk assessment. Advice remains that neither aspirin, nor any other medication, should be stored in first aid kits. It should be emphasised that the administration of 300mg of aspirin can have very real benefits for a suspected heart attack. We would like to thank Dr. Andrew Moore, senior scientific officer for the HSE for his help in this very important matter and his quick response to our correspondence.
We would be very interested to hear you comments on this matter.