A patient presents with suspected acute coronary syndrome. Which aspirin administration is appropriate for EMTs under standard protocols?

• A. Administer chewable aspirin 162–324 mg if not allergic and able to swallow
• B. Administer aspirin to any patient with chest pain
• C. Administer aspirin only if the patient has a bleeding risk
• D. Never administer aspirin under any circumstance

Answer: (A)

In suspected acute coronary syndrome, aspirin helps by inhibiting platelets to prevent further clot growth, which lowers mortality and heart damage. The best EMS approach is to give chewable aspirin in a dose of about 162–324 mg if the patient is not allergic and can swallow. Chewing the tablet speeds absorption, so the antiplatelet effect begins sooner—an important advantage when time matters in ACS. A typical way to reach that dose is two to four 81 mg chewable tablets.

Contraindications matter: if the patient is allergic to aspirin or has active bleeding or another clear bleeding risk, you should not give it. Giving aspirin to every chest-pain patient or never giving it would either be inappropriate or unsafe, respectively, because aspirin has proven benefit in appropriate ACS scenarios.