Those with chest pain will be told to take a tablet while waiting for ambulance.

By Susan Weich and Mark Schlinkmann
St. Louis Post-Dispatch

ST. CHARLES COUNTY, Mo. — Take one aspirin and wait for the ambulance.

That's the advice 911 callers with chest pain may get in St. Charles County starting Dec. 1, and dispatching services in other parts of the area are considering following suit.

While the aspirin direction isn't surprising, it is new for St. Charles County dispatchers, who usually tell patients to refrain from taking over-the-counter medications or eating or drinking anything before paramedics arrive.

The new instruction was issued recently by the National Academies of Emergency Dispatch, a medically approved agency that provides guidelines for what dispatchers say.

Aspirin helps improve blood flow to the heart in patients experiencing any acute coronary syndrome, said Dr. Jeff Clawson, co-founder of the national group.

While aspirin does not act as a blood thinner, as many people believe, it does grease the platelets, allowing blood to flow more freely, he said.

Dr. Richard Bach, a cardiologist at Barnes-Jewish Hospital, said the new policy is a great idea.

"The earlier we treat them (with aspirin), the better," said Bach, the hospital's director of cardiac intensive care. "Any treatment provided at such an early time point should provide benefit."

Bob Watts, director of St. Charles County Dispatch and Alarm, said taking aspirin could make a difference even if an ambulance takes as little as four or five minutes to get to the scene.

So far this year, St. Charles County dispatchers have handled nearly 2,000 calls regarding chest pain or a suspected heart attack.

"Even if the aspirin worked in just one-tenth of 1 percent of the cases, that's still two lives saved," he said.

Patients younger than 16, those allergic to aspirin or those with stomach or bleeding problems, would not be told to take the pill, Watts said.

Dispatchers also will ask patients for the name brand of the aspirin, to make sure it is not another drug.

Then they'll instruct the patient to chew the aspirin or place it under the tongue, to get it into the bloodstream as quickly as possible, Watts said.

Watts said he believes St. Charles County Dispatch and Alarm, which covers the entire county, will be the first government-run dispatch in the metro area to tell certain 911 callers to take aspirin.

Abbott Ambulance — which does emergency medical dispatching for some governments in the Metro East area — began a similar aspirin policy earlier this month. Abbott also began the policy for residents who call its Missouri ambulance service directly instead of 911 dispatchers.

Watts said other local agencies are in the process of implementing the procedure, he said.

Among them are Jefferson County 911 Dispatch, which covers much of that county. General manager Brenda Shular said she expected the new directions to be in place there by mid-December. She said the agency's medical control officer must first review the proposal.

In St. Louis County, officials of three major dispatching agencies — North Central County Fire Alarm System Inc., Central County Emergency 911 and South County Fire Alarm Association — said they all are considering adopting the policy.

Michael Turner, executive director of Central County, which covers much of west St. Louis County and about half of Franklin County, said if his agency's medical adviser signs off on the idea, it will be put into effect immediately.

"I suspect we'll hear any day," he said.

In St. Louis, Robert Hardy III — the city emergency medical service director — said the city typically follows the national organization's recommendations and that he plans to review this one. 

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