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The first randomised controlled trial of aspirin in the prevention of vascular events was conducted in South Wales in 1974.1 Since then overviews of numerous trials2 3 have established aspirin, used in cardiovascular disease, as the most thoroughly tested and the most highly cost effective drug available in clinical practice. Aspirin is now a standard part of both the early and the long term management of coronary thrombosis. Unfortunately, there is evidence that within Wales only about half such patients are actually taking this drug.4 Other research has identified that poor compliance is not confined to Wales. A number of doctors taking part in the US Physicians Health Study admitted that they had taken aspirin on less than half the study days.5
The administration of aspirin by a doctor or paramedic on first contact with a patient who has chest pain and is judged to possibly have had a myocardial infarction (MI) is accepted practice.6 It would seem to be logical and highly desirable for appropriate training in life saving intervention with aspirin to be given to every person who is trained in cardiopulmonary resuscitation (CPR) or basic first aid. It is perhaps surprising that “first responders” trained to use automated external defibrillators in the Department of Health National Defibrillator Programme are not taught to administer aspirin …
Competing interests: None.
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