Leigh,

As others have pointed out this is incorrect advice. I am not sure what signs and symptoms you are talking about but heart attacks and strokes very rarely mimic each other. You were right about getting a patient to calm down and call 911, but your advice strays from the accurate from there.

So what are the (short list) signs and symptoms of a Heart Attack (AMI: Acute myocardial infarction) and Stroke (CVA: Cerebrovascular Accident)?

AMI

• Pain in chest, back (between should blades)may be described as a heaviness or squeezing but absence of these descriptive phrase should not be used as a "rule-out".
• Shortness of breath
• Sweating
• "Indigestion" or Nausea

CVA

• Alterered Level of Consciousness
• Impaired motor function (may be one sided)
• Difficulty speaking or loss of speech
• Headache (often described as the worse ever experienced by the patient, which can be a major indicator that it is a Hemorrhagic vs. Ischemic CVA)

These are both short lists, but get the point across.

Aspirin is considered one of the second-line medications in an patient experience "Pain of a probably cardiac origin", with Oxygen being the first-line medication and Nitroglycerin and Morphine following the administration of Aspirin. Note the vagueness of the term "Pain of a probably cardiac origin". It is specifically vague because we are treating a SYMPTOM prior to the diagnosis, and it is the treatment of choice for this symptom as recommended by the American Heart Association (specifically 162 to 324mg or 2-4 baby aspirin chewed). I am not even going to look at a ECG (and either are most other ACLS providers including MD) to help determine if I should administer Aspirin; your having Chest Pain or similar pain... your not allergic to Aspirin... your are able to chew and swallow on your own... you are getting the Aspirin.

Aspirin alone won't stop a heart attack, but repeated research has shown that early administration of Aspirin after the onset of sign and symptoms of a heart attack can greatly improve the eventual outcome. Calling 911 as soon as possible should be your primary priority.

I don't know if I would go so far as to classify ANY of those three medications as "safer". All have their dangers and their beneficial uses. Each medication has been proven to not only be safe but effective if used as directed and intended.

FWIW, I have seen more patients with long-term health issues due to Acetaminophen abuse (intentional and accidental) then either of the other two mentioned mediations. Doesn't make it unsafe, just a warning to follow the direction and MD's orders... more is not always better.

An extremely good point. Even so called 'herbal' or 'home remedies' can be harmful if not used properly. And meds which are 'safe' might not be depending on the patient or the combination which they are taken with other medication.

I once took some ColdFX and some back pain meds which had a high dose of asprin. I later had a bloody nose which wouldn't stop. I'm prone to bloody noses but in my thirty years I'd never had one where the blood came out thin like water.

I later did the homework and learned that asprin thins the blood...and that ColdFX is full of ultra concentrated Ginseng...another blood thinner.

There is a bison capsule with 325mg Bayer on my vehicle keys.

While all NSAIDs (acetaminophen, ibuprofen, naproxen, etc.) all have legitimate uses, they all also have the potential for significant side effects. The longer you take them, the higher the dose, the more likely you are to have side effects. As it is relevant to this thread, ONLY ASPIRIN has any utility in reducing the effects of a heart attack.

In regards to reduction of mortality (reduce the chance of dieing), only aspirin and beta-blockers have been shown to be effective. O2, NTG, and morphine relieve symptoms but don’t reduce mortality. From a practical standpoint only ambulances would have prehospital access to O2 and morphine.

"...only ambulances would have prehospital access to O2..."

We carry O2 with us, "just in case." Got the regulator (the most expensive part) and a couple of empty bottles at a yard sale (after the death of an old person), went to a med supply store and swapped the empties for full bottles for a reasonable price. Nasal canulas are readily available and cheap. You can probably get your family doctor to write a prescription for O2 if you ask. Cheap insurance...

I think the critique has been beat enough.

There is a type of stroke which could be made much worse by aspirin, a hemorrhagic stroke. Otherwise known as bleeding into the brain.

But, as so well pointed out, for people with even a smattering of diagnostic skill a stroke and heart attack are not all that easy to mistake for one another.

That said Leigh_Ratcliffe makes a good point about not assuming too much or jumping in too soon. Keeping the person calm and calling 911 is not bad advice. Most city and suburb dwellers are so close to 911 advice and EMT/rescue services that waiting until your advised to give aspirin or for the troops to arrive isn't much of a risk.

There is certainly still some risk of an unknown allergy or unexpected interaction. Some number of people likely to have a heart attack are already on aspirin and/or other blood thinners that could make them very prone to bleeding. So stuffing aspirin into people you happen to think are having a heart attack isn't something you want to do casually. Every therapy and drug has side effects. Don't go off half-cocked.

In more remote locations, or when emergency services are overwhelmed or unavailable, your much more on your own. Assuming 911 still works and realizing that EMTs are not on the way they may advise you to administer aspirin.

I don't carry aspirin on me but all of my first-aid kits have some aspirin in them. Even the tiniest one has a couple of single-dose foil packets in them.

Aspirin is good stuff. Good for fevers (But not for kids because of Rye syndrome), headaches and moderate pain. Also not for a person with serious bleeding, internally (As is possible after an auto accident or hemorrhagic stroke) or the much more obvious external bleeding.

Generally Tylenol is safer and less likely to interact with other drugs but it is much more toxic to the liver than other OTC pair relievers. So don't take Tylenol for a hangover or when the person is jaundiced or shows signs of their liver being under stress. But Tylenol is good. It will take the edge off of a lot of pain.

Generally Ibuprofen is my go-to pain relief for joint or bone pain. It seems to work better for this than Tylenol.

I think the critique has been beat enough.

There is a type of stroke which could be made much worse by aspirin, a hemorrhagic stroke. Otherwise known as bleeding into the brain.

But, as so well pointed out, for people with even a smattering of diagnostic skill a stroke and heart attack are not all that easy to mistake for one another.

That said Leigh_Ratcliffe makes a good point about not assuming too much or jumping in too soon. Keeping the person calm and calling 911 is not bad advice. Most city and suburb dwellers are so close to 911 advice and EMT/rescue services that waiting until your advised to give aspirin or for the troops to arrive isn't much of a risk.

There is certainly still some risk of an unknown allergy or unexpected interaction. Some number of people likely to have a heart attack are already on aspirin and/or other blood thinners that could make them very prone to bleeding. So stuffing aspirin into people you happen to think are having a heart attack isn't something you want to do casually. Every therapy and drug has side effects. Don't go off half-cocked.

In more remote locations, or when emergency services are overwhelmed or unavailable, your much more on your own. Assuming 911 still works an

In regards to reduction of mortality MUCH more then ASA and beta blockers have been shown to be effective. Nitro and Morphine along with Aspirin and Oxygen has been shown to improve short term mortality and while not the definitive care for a MI they are the like aggressive bleeding control in a GSW patient... they will get you to the definitive care.

I don't know where you level of knowledge, training or experience is but your post reads as a paraphrasal or Wikipedia



Another good point and one I meant to make but missed. What medications we carry as laypersons should (in most cases) be kept for use on us and or families. Someone asks you for an Aspirin, fine but otherwise keep you treatments (and giving someone a drug or any kind, OTC or otherwise is a treatment) to within you scope of practice.