Aspirin is commonly administered for acutecoronary syndromes in the prehospital setting. Fewstudies have addressed the incidence of adverseeffects associated with prehospital administrationof aspirin. Objective: To determine the incidenceof adverse events following the administration ofaspirin by prehospital personnel.

Multi-center, retrospective, case series thatinvolved all patients who received aspirin in theprehospital setting from (01 August 1999–31January 2000). Patient encounter forms of theemergency medical services (EMS) of a metropolitanfire department were reviewed. All patients whohad a potential cardiac syndrome (i.e., chestpain, dyspnea) as documented on the EMS forms wereincluded in the review. Exclusion criteriaincluded failure to meet inclusion criteria, andchest pain secondary to apparent noncardiac causes(i.e., trauma). Hospital charts were reviewed froma subset of patients at the participatinghospitals. The major outcome was an adverse eventfollowing prehospital administration of aspirin.This outcome was evaluated during the EMSencounter, at emergency department discharge, orat six and 24-hours post-aspirin ingestion. Anadverse event secondary to aspirin ingestion wasdefined as anaphylaxis or allergic reactions, suchas rash or respiratory changes.

A total of 25,600 EMS encounter forms werereviewed, yielding 2,399 patients with a potentialcardiac syndrome. Prior to EMS arrival, 585patients had received aspirin, and 893 wereadministered aspirin by EMS personnel. No patientshad an adverse event during the EMS encounter. Ofthese patients, 229 were transported toparticipating hospitals and 219 medical recordswere available for review with no adversereactions recorded during their hospitalcourse.

Aspirin is rarely associated with adverse eventswhen administered by prehospital personnel forpresumed coronary syndromes.