A patient with chest pain has an aspirin allergy. What should you do?

A patient with chest pain has an aspirin allergy. What should you do?

• A. Administer aspirin to treat pain despite allergy
• B. Withhold oxygen and nitro to give aspirin
• C. Delay all therapies until confirming allergy with a pill test
• D. Do not give aspirin; continue with other protocol therapies (oxygen, nitro if indicated and not contraindicated)

Answer: (D)

The key idea is handling suspected ACS with the safest, most effective protocol while honoring known allergies. Aspirin is given in chest-pain scenarios because it helps prevent clot growth, reducing mortality, but it must be withheld if there is a confirmed aspirin allergy due to the risk of a serious hypersensitivity reaction. In this situation, you should not give aspirin. Instead, continue with the other parts of the protocol that are appropriate and not contraindicated: provide oxygen if the patient is hypoxic or at risk for hypoxia, and administer nitroglycerin if indicated and not contraindicated (for example, if blood pressure is adequate and there are no PDE-5 inhibitors or other nitro contraindications). Delaying all treatment to verify the allergy or attempting a pill test would waste critical time and worsen outcomes. So, omit aspirin and proceed with the remaining therapies (oxygen and nitro as indicated) and rapid transport.

The key idea is handling suspected ACS with the safest, most effective protocol while honoring known allergies. Aspirin is given in chest-pain scenarios because it helps prevent clot growth, reducing mortality, but it must be withheld if there is a confirmed aspirin allergy due to the risk of a serious hypersensitivity reaction. In this situation, you should not give aspirin. Instead, continue with the other parts of the protocol that are appropriate and not contraindicated: provide oxygen if the patient is hypoxic or at risk for hypoxia, and administer nitroglycerin if indicated and not contraindicated (for example, if blood pressure is adequate and there are no PDE-5 inhibitors or other nitro contraindications). Delaying all treatment to verify the allergy or attempting a pill test would waste critical time and worsen outcomes. So, omit aspirin and proceed with the remaining therapies (oxygen and nitro as indicated) and rapid transport.