Aspirin Administration By EMDs

Heather Darata

Heather Darata

Blast From The Past
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When remote aspirin administration was introduced by the Medical Priority Dispatch System in 2007, there was some initial hesitation. Not only was the Aspirin Diagnostic and Instruction Tool new (Version 11.3a), but emergency dispatchers weren’t accustomed to providing instructions for administering medications over the phone.

Medical Directors needed to sign off—and still do—before their agency would be allowed to use the Aspirin Diagnostic and Instruction Tool (ADxT) to qualify patients for aspirin administration. Before the introduction of the ADxT, EMDs did not provide administration instructions for any medications. The idea of screening callers with the purpose of qualifying patients to receive medicine would affect a much larger group of patients in the future.

This idea took some getting used to. Fast forward five years. By 2012, about 60% of centers using the MPDS® were using the ADxT. Dr. Jeff Clawson put together a novel presentation about aspirin administration at dispatch for the EMS Global Alliance’s Gathering of Eagles Conference that year.

In his presentation, Dr. Clawson shared how he built upon the idea of the Drake Equation (it determines how many intelligent, communicating civilizations there are in our Milky Way galaxy, initially from 1,000 to 100 million) by creating the Clawson Equation, which calculates time saved through prearrival aspirin administration by EMDs.

His conclusion, which was calculated by the Clawson Equation (see the attachment for the details of what went into the equation), showcased the  phenomenal time of 108 years saved through pre-arrival aspirin administration by EMDs in its first four years. Even more amazing than the 108 years saved is the fact that this number was calculated in 2012—10 years ago. Another decade has passed and with more centers using the ADxT, the number of years saved has only increased—and significantly.

In addition to the amount of time saved not waiting for aspirin, the Aspirin Diagnostic and Instruction Tool has been the harbinger of lifesaving medication additions to later versions of the MPDS. These three protocols weren’t available until MPDS v13.0 was released in 2015—eight years after aspirin administration was introduced:
Protocol P: Epinephrine (Adrenaline) Auto-Injector Instructions
Protocol Q: Narcan/Naloxone Nasal Instructions
Protocol R: Naloxone Auto-Injector (Evzio) Instructions

What may have started out with a lot of uncertainty on the part of EMDs, their agencies, and their medical directors with the introduction of the ADxT has morphed into a clear standard of care and practice for emergency dispatch that includes administration of critical medicines over the phone before responders are on scene. And that makes remote patient care that much better.