In the event that a responsive patient is suffering from non-traumatic chest pain due to Acute
Coronary Syndrome (ACS), rescuers can assist patients in taking their own ASA (acetylsalicylic
acid/Aspirin) as part of the treatment protocol.

It is the position of the Lifesaving Society and the BC & Yukon Branch that medication only be administered to the person that it has been prescribed to and within the expiry date as marked on the label. Research has shown that the administration of non-prescription ASA to a patient suffering from non-traumatic chest pain due to ACS (angina and heart attack) can be beneficial. RATIONALE:
The BC & Yukon Medical Advisor recommends the use of ASA to a patient suffering from ACS as the benefits far outweigh the small risks associated with its use. Although ASA will not make the pain go away, it can help to stop clotting in the arteries, thus reducing damage to the heart. Although the First Aid program trains candidates on an ASA protocol, rescuers must consult, and comply with, their employer’s policies and procedures with respect to medication administration. The following treatment guidelines have been established to assist Rescuers in the administration of ASA: 1) Recognize the signs and symptoms of ACS to include: • Anxiety, fear and/or confusion • Denial or “Indigestion” • Shortness of breath • Weak and rapid pulse • Skin to include… 9 pale skin with flushed cheeks and/or grey overtones 9 sweating 9 cyanosis 9 tightness in the centre of the chest 9 pain lasting longer than 30 minutes 9 Radiating pain through the shoulders, arms, jaw and through the back • Nausea and/or vomiting • Weakness, dizziness and fatigue Lifesaving Society Position Statement – ASA Administration
• Scene Assessment and patient history (traumatic vs non-traumatic chest pain) • Call EMS • Complete the Primary Survey to include ABCs and check for the presence of bleeding • Assist victim into position of comfort (sitting) and loosen tight clothing • If the patient has nitroglycerine, assist them in taking their medication… 9 unless they have taken any drugs for erectile dysfunction (Viagra, Cialis, Levitra) 9 not to exceed 3 doses in 10 minutes • If the patient has their own ASA (acetylsalicylic acid/Aspirin), assist them in taking it 9 they are not allergic to ASA or ibuprofen 9 they do not have a history of Asthma (ASA can be a bronchial constrictor) 9 it has not been contraindicated by their physician 9 they do not have an active gastrointestinal (stomach) bleed or a recent traumatic • Have the patient chew (1) adult ASA tablet (325mg) or (2) children’s ASA tablets
DO NOT substitute acetaminophen (Tylenol) or ibuprofen (Advil/Motrin) as they block the
blood-thinning affect of ASA (anticoagulants). 3) The following guidelines must be followed if a Worksite Level 1 Attendant will be administering ASA to a co-worker as per the OHS Guidelines Part 3. “Non-prescription drugs supplied by the employer should be under the control of the attendant or other authorized representative of the employer.” “Non-prescription drugs must be used in accordance with the drug manufacturer's recommendations or specific instructions from a physician or qualified practitioner.” “Before supplying non-prescription drugs or medications to a worker where there are no specific instructions from a physician or qualified practitioner, the first aid attendant should: i. Be familiar with the side effects, contra-indications, and indications for use listed by the manufacturer (of particular concern are drugs or medications that cause drowsiness or interfere with alertness and manual dexterity required by workers to perform their duties) ii. Inform the worker of any side effects or contra-indications iii. Not supply drugs or medication past the expiry date iv. Obtain a history of events leading up to the worker asking for relief v. Determine if the worker is currently taking any medication and, if so, the appropriateness of taking additional medication vi. Where required, make an entry in the first aid records BC & Yukon Branch
#112 - 3989 Henning Drive Burnaby, BC V5C 6N5
Telephone: 604.299.5450 Fax: 604.299.5795
Lifesaving Society Position Statement – ASA Administration

Canadian First Aid Manual (2005 CPR Guidelines) – Circulatory Emergencies (pg. 34) Angina and heart attacks – victim and incident history: “If the victim does not have prescribed medication, another option is ASA…” Canadian Heart & Stroke Foundation OHS Guidelines Part 3 (Occupational First Aid - Added March 30, 2004) BC & Yukon Branch
#112 - 3989 Henning Drive Burnaby, BC V5C 6N5
Telephone: 604.299.5450 Fax: 604.299.5795



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