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.