Aspirin Administration for Acute Coronary Syndrome (ACS) in Emergency Department (ED) and Pre Hospital Care (PHC) at Cluster Hospitals in Central Selangor: A Prospective Study

Introduction Early aspirin administration has been shown to significantly reduce acute myocardial infarction mortality rate in ACS patients. Various guidelines mentioned to give aspirin early but the knowledge, attitude and practice (KAP) of healthcare workers (HCWs) in ED and PHC regarding aspirin administration has not been explored. This study aims to investigate the KAP of aspirin administration among ACS patients in ED and PHC in cluster hospitals in Selangor.  

Methodology This is a multi-centre, cross-sectional questionnaire-based study conducted in cluster hospitals in central Selangor. Doctors, nurses and medical assistants working in ED and PHC were randomly sampled to answer the questionnaire. The questionnaire was validated by ED and PHC seniors with cardiac post-basic and a pilot study was conducted prior to data collection. 

Results A total of 272 responses were obtained, with fair distribution in gender and professions. Most of the responders were 20-30 years old (n=180, 66.2%) and with 1-5 years working experience (n=202, 74.2%). About 50% of responders were aware that aspirin is the first drug given and 70-89% of them practice giving aspirin as the first drug (doctors=89.4%, medical assistants=80%, nurses=69.9%). Majority (>90%) served aspirin correctly, either crush, dissolve and swallow or chew and swallow. Less than half would serve aspirin if patient is allergic to painkillers such as mefenemic acid (doctors=44.7%, medical assistants=44.2%, nurses=43.5%). 

Conclusion Overall, HCWs in ED and PHC have high tendency to serve aspirin to ACS patients but need to be more confident when they encounter patients with contraindications or hypersensitivity to aspirin.   

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