急性心肌梗塞病人的阿斯匹靈藥物使用

Administration of Aspirin in Patients with Acute Myocardial Infarction

李芳年(Fang-Niarn Lee) ； 胡勝川(Sheng-Chuan Hu) ； 高偉峰(Wei-Fong Kao) ； 羅鴻彰(Hong-Chang Lo) ； 李建賢(Chen-Hsen Lee)

《中華民國急救加護醫學會雜誌》 8卷1期 (1997/03) Pp. 13-17

https://doi.org/10.30018/JECCM.199703.0003

摘要

Aspirin is an essential drug in the early management of patients with an acute myocardial infarction (AMI), independent of whether thrombolytic therapy is used. We conducted an observational study to evaluate the appropriateness of aspirin administration in the management of AMI patients.
One hundred and thirty-five consecutive patients, admitted to the coronary care unit (CCU) via the emergency department (ED) diagnosed as having AMI, were enrolled in this study from December 1995 to May 1996. Patients demographics, cardiac history, symptoms, time of acute symptom onset, time of AMI diagnosis, administration of aspirin, and method and timing of dispensing were evaluated.
The time interval between symptom onset and AMI diagnosis was 946 (range, 30-8010) minutes. Aspirin was given in 99 (73.3%) of the patients. Seventy five patients were transferred from other hospitals, in whom, aspirin was started in 23 (30.7%) patients by the initial hospital. The aspirin was chewed and then swallowed in only 5 (21.7%) of the 23 patients. Aspirin was given to 30 of the 52 transferred patients who had not received it previously after arrival at our hospital. !n the non-transferred patient group (n=60), aspirin was given to 46 patients. The overall aspirin prescription rate in our hospital was 67.9%, (30+46)/(52+60). Of these 76 patients, only 33 (43.4%) patients chewed the aspirin before swallowing.
Immediate aspirin (160-325 mg) administration is recommended for patients with AMI. The aspirin should be chewed to allow for a more rapid onset of action. The present study indicates resident training defects and/or inadequate attending supervision in the immediate management of AMI patients. The principles of advanced cardiac life support (ACLS) training need to be adhered to improve AMI care among our patients.

關鍵字

急性心肌梗塞 ； 標準照護流程 ； 阿斯匹靈 ； 高級心臟救命術

並列摘要

Aspirin is an essential drug in the early management of patients with an acute myocardial infarction (AMI), independent of whether thrombolytic therapy is used. We conducted an observational study to evaluate the appropriateness of aspirin administration in the management of AMI patients.
One hundred and thirty-five consecutive patients, admitted to the coronary care unit (CCU) via the emergency department (ED) diagnosed as having AMI, were enrolled in this study from December 1995 to May 1996. Patients demographics, cardiac history, symptoms, time of acute symptom onset, time of AMI diagnosis, administration of aspirin, and method and timing of dispensing were evaluated.
The time interval between symptom onset and AMI diagnosis was 946 (range, 30-8010) minutes. Aspirin was given in 99 (73.3%) of the patients. Seventy five patients were transferred from other hospitals, in whom, aspirin was started in 23 (30.7%) patients by the initial hospital. The aspirin was chewed and then swallowed in only 5 (21.7%) of the 23 patients. Aspirin was given to 30 of the 52 transferred patients who had not received it previously after arrival at our hospital. !n the non-transferred patient group (n=60), aspirin was given to 46 patients. The overall aspirin prescription rate in our hospital was 67.9%, (30+46)/(52+60). Of these 76 patients, only 33 (43.4%) patients chewed the aspirin before swallowing.
Immediate aspirin (160-325 mg) administration is recommended for patients with AMI. The aspirin should be chewed to allow for a more rapid onset of action. The present study indicates resident training defects and/or inadequate attending supervision in the immediate management of AMI patients. The principles of advanced cardiac life support (ACLS) training need to be adhered to improve AMI care among our patients.

並列關鍵字

acute myocardial infarction ； advanced cardiac life support ； aspirin ； standard care