In a patient with chest pain, which action is most appropriate to perform first in the prehospital setting?

• A. Attach AED
• B. Administer Aspirin
• C. Obtain vitals
• D. Administer oxygen by NRB

Answer: (B)

When a patient has chest pain with suspected acute coronary syndrome, giving aspirin promptly is the most beneficial early step. Aspirin helps by inhibiting platelet aggregation, which slows clot growth in the coronary artery and can reduce heart damage. Because it acts quickly when chewed, it can be administered while you continue the assessment and transport, and it is safe for most patients who are not allergic or actively bleeding. Dosing is typically a single chewable tablet or two to four tablets totaling about 160–325 mg. Oxygen is reserved for those who are hypoxic or in respiratory distress, since routine oxygen for all chest pain patients isn’t always beneficial. Getting vital signs and ECG monitoring are important ongoing steps, and an AED is used only if the patient becomes unresponsive or pulseless.