Emergency department use of aspirin in patients with possible acute myocardial infarction

Background: Efforts have been made to improve the suboptimal use of aspirin af Objective: To assess the frequency and timing of aspirin administration in emergency department patients with possible myocardial infarction. Design: Retrospective record review. Setting: Emergency departments of four hospitals affiliated with the same university. Patients: All patients who were admitted to the four hospitals in 1994 for evaluation and treatment of suspected acute myocardial infarction. Measurements: The frequency and timing of aspirin administration and the definitive diagnosis established before discharge from the hospital. Results: Aspirin was not given to 253 of 463 emergency department patients (55%) who had a definitive diagnosis of acute myocardial infarction. Seventy-eight pet-cent of patients who did receive aspirin received it more than 30 minutes after arrival in the emergency department. Conclusion: Aspirin therapy is underutilized as the first intervention in patients who are admitted with suspected myocardial infarction.