Editor’s Note: This is part one of a four-part series.
The International Liaison Committee on Resuscitation (ILCOR) defines first aid as “helping behaviors and initial care provided for an acute illness or injury.” Noting the paucity of evidence regarding these treatments, in 2013, ILCOR appointed a task force to prepare recommendations regarding initial care by trained or untrained rescuers for the 2015 American Heart Association (AHA) and American Red Cross Guidelines Update for First Aid, which were released with the 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.
The task force included emergency physicians from throughout the world. The goal was to provide an evidence base for the initial care provided by laypersons, EMS, and physicians outside of the office or hospital setting. These first aid competencies include, at any level of training:
- Recognizing, assessing, and prioritizing the need for first aid
- Providing care by using appropriate knowledge, skills, and behaviors
- Recognizing limitations and seeking additional care when needed
In order to review these recommendations, ACEP Now has partnered with three emergency medicine residency training programs (Wake Forest School of Medicine, Winston-Salem, North Carolina; Mayo School of Graduate Medical Education/Mayo Clinic, Rochester, Minnesota; and Warren Alpert Medical School of Brown University, Providence, Rhode Island) to review 15 of these recommendations following the PICO (Population, Intervention, Comparator, and Outcomes) analytic format utilized by the recommendation authors.
Howard Mell, MD, MPH, CPE, FACEP, assistant professor, Wake Forest Baptist Medical Center, Department of Emergency Medicine Jessica L. Smith, MD, FACEP, associate professor (clinical), Warren Alpert Medical School of Brown University, and program director, Emergency Medicine Residency Jason Stopyra, MD, FACEP, assistant professor, Wake Forest Baptist Medical Center, Department of Emergency Medicine Matthew Sztajnkrycer, MD, PHD, FACEP, associate professor, Mayo Clinic, Department of Emergency Medicine
Reference: Singletary EM, Charlton NP, Epstein JL, et al. Part 15: first aid: 2015 American Heart Association and American Red Cross Guidelines Update for First Aid. Circulation. 2015;132(suppl 2):S574–S589.
Aspirin for Chest Pain (FA 871)
Recommendation Author: Erika M. McMahon, MD
Dr. McMahon is a member of the Emergency Medicine Residency Training Class of 2017 at the Mayo School of Graduate Medical Education/Mayo Clinic.
Question: Among adults experiencing chest pain due to suspected myocardial infarction (P), does administration of aspirin (I) compared with no administration of aspirin (C) change cardiovascular mortality, complications, adverse effects, incidence of cardiac arrest, cardiac functional outcome, infarct size, or hospital length of stay (O), and does early administration of aspirin change these outcomes or chest pain resolution compared with late administration?