Pharmacists can play an important role in precautionary and emergency medicine. All pharmacists who are authorized to administer vaccines and other injections are certified to perform cardiopulmonary resuscitation (CPR) in case of an emergency. Many of these pharmacists have also been trained to use automatic external defibrillators (AEDs) in patients who are having a cardiac arrest. In addition to CPR and AED use, pharmacists receive education on how to properly administer an epinephrine injection in case of anaphylaxis, and an increasing number of pharmacists are learning to administer injectable or intranasal naloxone for overdose situations. Similarly, pharmacists should consider playing a more active role in the emergency treatment of patients who are having heart attacks.
Unlike many of the ways that pharmacists prepare for emergency situations, no additional training is needed to prepare pharmacists to treat a patient who is having a heart attack. Instead, pharmacists should consider the positive impact of carrying aspirin—on and off the job. It is well-documented that taking aspirin during a heart attack inhibits platelet aggregation, and is associated with better patient outcomes.1 When a patient is having a heart attack, pharmacists should recommend that the patient chew a single 325-mg aspirin tablet. The Harvard Medical School reports that chewing aspirin allows the drug to work within approximately 5 minutes, whereas a swallowed tablet takes 12 minutes to work.2 Chewing the aspirin allows the agent to reach the blood stream quicker, and when every minute counts, a 7-minute difference can be significant.
Pharmacists can purchase keychain pill cases for a few dollars and fill them with aspirin so that they have the drug with them at all times. Single-use packets of aspirin are also available at many retail pharmacies. At pennies per tablet, cost should not be an issue. This simple, noninvasive act of carrying aspirin prepares pharmacists to act and administer help in emergency situations, and no extra training is needed.
Unlike the case of precautionary medicine components, such as CPR training or AED use, pharmacists can also counsel their patients on how to act as emergency responders in the case of a heart attack. Such education is beneficial for all patients, because their family, friends, and coworkers could be at risk. For pharmacists looking for ways to proactively counsel patients, identifying patients taking cardiac medications can be an easy first step. These individuals are primary candidates for carrying aspirin, and could benefit from counseling on the use of aspirin during a heart attack. This is another great topic to discuss at public outreach events, pharmacy store tours, or visits to senior citizen centers.
A large, over-the-counter aspirin manufacturer has recently launched a website dedicated to heart health. This website—www.IamProHeart.com—provides a tool that helps patients to assess their risk for a heart attack or a stroke. The website provides information on the signs and symptoms of a heart attack, and also includes an awareness campaign called the HeroSmiths. The premise of the HeroSmiths campaign is that carrying aspirin can help save a life. More than 2.4 million Americans have the last name Smith, and if they all carried aspirin, fewer people may die from heart attacks.
Aspirin is a low-cost, readily available medicine that can help save your patients’ lives. By carrying aspirin with you at all times, you can position yourself to assist patients, and the general public, in case of a heart attack. This is yet another way that we, as pharmacists, can demonstrate our value as healthcare professionals. With an aging population, this preventive step may become increasingly more important.
- US Preventive Services Task Force. Aspirin for the prevention of cardiovascular disease: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2009;150:396-404.
- Harvard Health Publications Harvard Medical School. Aspirin for heart attack: chew or swallow? Updated October 9, 2015. www.health.harvard.edu/heart-health/aspirin-for-heart-attack-chew-or-swallow. Accessed March 20, 2017.