Hi. Quick break from the posting for a serious PSA.
Please have a bottle of aspirin in your home. Make sure the tablets can be chewed as well as just swallowed. Make sure you remove any fiddly foil seal and such. Don't use this aspirin for regular pain relief, just keep it around and know where it is.
Hopefully, you'll never need it and will just feel silly for having it. But if a bad time comes for you someday, being able to chew aspirin when emergency services tells you may save your life.
Aspirin is an anticoagulant, meaning it reduces your blood's ability to clot. Normally this is an undesirable side effect, because if you're bleeding you want your blood to clot and stop the bleeding.
But heart attacks and other cardiovascular events can be caused by blood clots obstructing blood vessels. Your body's not supposed to let that happen, but for various reasons sometimes it does. When it does, minutes count and you need to tip the odds in your favor.
Fastest way to do that without a hospital is to chew some aspirin. Chewing it breaks through the outer coating that's meant to delay release of the active compound, and dumps anticoagulant into your bloodstream as quickly as possible.
It won't magically solve clots that are already there, but it's putting your finger on the scale. Your body is constantly in a tug of war between biological pathways that want to form clots, and pathways that prevent and dissolve them.
Chewing aspirin is like sending reinforcements to the "pls no clots" faction of your body, as quickly as possible. It stops new clots forming, and existing ones growing. It gives your body some extra margin that it can use to start dissolving the one(s) causing your cardiac event.
It's not a cure, not even close. It's an emergency mitigation that may buy you extra time while paramedics reach you and get you further help.
Note, this is something you want to have available, but you should not freelance it. If you think you're having a heart attack, embolism or other cardiac event, call 911/999/112/whatever your local version is, tell them where you are and what's happening, that you have aspirin and aren't allergic, and follow their instructions.
In some countries you can buy "low dose" aspirin, which come with slightly different instructions. That's ok too.
Once you get to a hospital, assuming blood clots are an issue, then you'll get on the really good stuff like IV heparin, to continue what the aspirin started. But you can't keep that in a bathroom cabinet at home, and if a clot is trying to kill you, the sooner you get some anticoagulation going, the more chance you have of a good outcome. You do not want to have to wait until arrival at the ER, or even until paramedics reach you. As soon as possible. Give yourself the option.
This PSA brought to you by: hi! I just had a serious pulmonary embolism, and spent a couple days in intensive care. I'm okay, the immediate danger has passed, though full recovery will take a while longer.
Having aspirin on hand allowed me to begin anticoagulation treatment within seconds of the bad time starting, and 10-60min sooner than waiting for first responders or ER treatment. There's a high chance that was the difference between "scary but you'll be fine" and an obit.
@danderson Yikes, wish you a good recovery! I've had 2 unprovoked DVT incidents and none of them have resulted anything serious but could have ended up much worse. Modern medicine incredibly makes what I had survivable compared to 100 years ago. I’m on anticoagulation these days to avoid any reoccurrence, even though they weren't able to track down an obvious cause.
@sdier Yeah I'm also in the random DVT club, though for reasons anticoagulation wasn't continued past acute treatment. Made it 10 years without incident, and then 😬
A lot of emergency preparedness stuff requires a bunch of work or money. "grab a bottle of aspirin at the shops" is incredibly cheap and easy, and while I hope you will never need to use it, if that particular grim reaper comes knocking someday, it may literally be what keeps you with us. It's extremely cheap insurance, please take it.
@danderson I am glad you’re okay but please be careful with this. Certain medications increase the risk of bleeding and so do certain medical conditions that you might not even know you have. I am on such a medication (with contraindications) and I have had such a condition. I also have had to have surgery multiple times for bleeding totally unrelated. I can’t take anything that thins blood. Okay there might have to be at some point but I have to be careful is all I mean.
@xexyl@danderson That's why he wrote that you should call 112 (or whatever in your country), tell them you have acetylsalycylacid and aren't allergic to it. And then only chew it if they say so.
@danderson Thanks for this PSA! I have a small bottle of chewable low dose aspirin on hand. But I hadn't thought to make it speedily available. When going to do that, I discovered it was expired! The shopping list has been updated.
I'll make my own PSA about it, but another thing to keep on hand in case emergency services asks for it is a lolipop for diabetic shock.
@danielcornell@danderson
you have to be careful with stroke. Basically there are two types of stroke:
ischemic or blood clot in the brain, for which anti coagulants like TPA are used.
However the other cause of stroke is hemorrhagic - which means a burst blood vessel of some sort - in this case you don't want anticoagulants.
@MsMerope@danielcornell Yeah, it's complicated. To reemphasize what a later post in the thread said: when I say keep aspirin around, I don't mean decide on your own whether or not to use it.
In an emergency, call the emergency services, tell them what's happening, and they will tell you whether aspirin should be taken, and how much. The goal is purely to be able to say "yes" if the operator asks you if you have aspirin available. They have training and workflows, follow their instructions.
@danderson yes! A good minor tweak — and what I have at home and in my first aid kits — is baby aspirin. Smaller doses mean more flexibility and they’re made to be chewable so aren’t as gross as munching a grown-up pill
@jacob Yes! Depending on country, you can get "daily low dose" aspirin, which is 1/4 the normal dose. It's primarily meant for doctor-supervised ongoing use, but the pills are also small, very chewable, and the bottle usually has a callout like "If you think you're having a heart attack: dial 911, then chew 2 tablets." That effectively gives you half a normal dose ASAP, and the operator can easily tell you "yup, good call, chew 2 more please".
@jacob One additional caveat: the emergency operator will want to know what the exact per-tablet dose is, so that they don't instruct you to dump a dangerous amount of anticoagulant. "it's baby aspirin" or "it's low dose" isn't enough, make sure you know how many milligrams of ASA per tablet. It can be hard to find the small numbers on the bottle when you're in a panic, familiarize yourself ahead of time.
@danderson yup, that's what I have in my FAKs - 81mg chewable pills.
My primary use case is wilderness medicine, so diagnosing a heart attack in the field is next to impossible and "dial 911" part requires satellites in the best case and is impossible in the worst. So the protocol for suspected heart attack is chew two (160 mg) every four hours while you attempt evac/rescue. That's a small enough dose to have negligible potential side effects while still maybe providing some benefit.
@jacob Yup, the 81mg stuff is what I have too. It's a good choice for a first aid stash, if it's available. Can confirm they are very chewable in an emergency 😬
And yeah, wilderness medicine is much trickier. IME at least, when 911 is involved they'll make you take a full 320mg since more help is minutes away and so it's worth the slight extra risk to tip the balance further.
@jacob Huh, from 160/4h to 320/day? That's interesting, seems like a decrease overall... I sort of assumed the anticoagulant effect was O(hours), but maybe it's longer?...
@jacob Digging around a bit, I lack a lot of necessary background knowledge in biology and pharmacology, but I think aspirin's anticoagulant effect happens by permanently disabling the ability of platelets to trigger mass aggregation and clotting. So, any platelet exposed to the ASA becomes worse at clotting for as long as the platelet stays in the bloodstream, long after the ASA has dissipated. Repeat dosing seems to be about controlling the % of nerfed platelets.
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