notsobuff

Just to stir the pot I suppose, but any chance that all of those elevations were just benign early repolarization unrelated to the chest pain?

Epi 1:1000 Epi 1:10000 NACL Haldol Promethazine Benadryl Vasopressin Albuterol Atrovent Lasix Amiodarone Lidocaine Atropine Aspirin Nitro SL Metoprolol Narcan Dopamine Mag Sulfate Adenosine Sodium Bicarb D50 D25 Calcium Chloride Glucagon Cardizem Morphine Valium

Your first "p" wave could have in fact been a U wave.

While I can see why the immediate reaction of the EMS community is that medication advice shouldn't be given over the phone, in this case there was no real potential for harm. Aspirin's anti-coagulative properties are most potent in the coronary system and least potent in the brain. This is why aspirin is never used to treat CVA patients, even after a CT shows no bleed; it simply wouldn't be effective. So even if the patient did have a bleed, it wouldn't have made the situation worse. The other thing to keep in mind is the abysmal morbidity rate for hemorrhagic CVA, so even if the aspirin were to promote bleeding, it wouldn't really change the final outcome. I suppose the bottom line for me is that there is a clearly demonstrated benefit for getting an MI patient aspirin as soon as possible, and it won't really change the outcome for a patient with a CVA, so instructing the patient to take a safe, readily available medication over the phone seems the right thing to do.