Patient Group Direction for the supply or administration of aspirin 300mg
tablets to hospital in-patients, or attendees of out of hours, minor injury
units and the emergency department presenting with suspected
myocardial infarction
This document authorises the supply or administration of aspirin 300mg
tablets by registered nurses to patients with suspected myocardial
infarction who meet the criteria for inclusion under the terms of the
document
The registered nurses seeking to supply or administer aspirin 300mg
tablets must ensure that all patients have been screened and meet the
criteria before supply takes place
The purpose of this Patient Group Direction is to decrease the length of
wait prior to aspirin administration in the event of a suspected myocardial
infarction in the absence of medical staff
This PGD was initially approved 1/5/2006
This direction was authorised on: October 2011
The direction will be reviewed by: October 2013
Clinician Responsible for Training and Review: Gillian Donaldson
Reviewed by: Helen Oxenham, Paul Neary, Gillian Donaldson
NHS Borders Aspirin PGD
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Patient Group Direction for administration of aspirin 300mg tablets without
a prescription for a named individual by registered nurses employed by
NHS Borders in hospital in-patients, or attendees of Out of Hours, Minor
Injury Units and the emergency department
1. This Patient Group Direction relates to the following specific preparation:
Name of medicine, Aspirin 300mg tablets
strength,
formulation
Legal status
GSL (General Sales List) or P (Pharmacy Only)
depending on pack size
Storage
Store in a dry place below 25°C
Dose
300mg immediately
Route/method
300mg should be chewed or dissolved in water for
rapid effect. This should be given even if the
patient has had aspirin previously that day.
Frequency
This should be given once only.
Total dose Quantity
300mg (one tablet)
(Maximum/Minimum)
Advice to Patients
Explain treatment and course of action
Relevant Warnings
 May cause nausea and vomiting.
Potential adverse drug reactions:
 Aspirin can irritate the GI mucosa and cause
bleeding/ulceration.
 Hypersensitivity reactions include rashes,
angioedema and bronchospasm.
 Please refer to current BNF or SPC for full
details
 Use the Yellow Card System to report
adverse drug reactions directly to the
Committee of Safety of Medicines.
Guidance on its use is available at the back
of a BNF.
Follow up
Arrangements
Patients with STEMI if not in BGH call 999 for
paramedic ambulance and follow STEMI protocol
regarding transfer to RIE or BGH
NHS Borders Aspirin PGD
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2. Clinical condition
Clinical Condition
Patient presenting with suspected myocardial
to be treated
infarction, in adults awaiting urgent transfer to the
BGH or NRIE
Criteria for inclusion
 Patients over the age of 16 presenting with
acute chest pain that is consistent with
myocardial infarction in site and duration.
(Regardless of previous aspirin intake that
day.)
 Signs of Myocardial infarction may include
autonomic upset such as sweating and
nausea, cardiogenic shock may be present
i.e. hypotension and tachycardia without
evidence of blood loss or infection
Criteria for
exclusion
Patients who:
 Are under 16 years old
 Are allergic to aspirin or other NSAID
 Are pregnant
 Have active peptic ulceration
 Have aspirin-sensitive asthma
 Have haemophilia or other clotting disorders
 Are taking oral anti-coagulants eg warfarin
 Have already received a dose of 300mg
aspirin before admission as an emergency.
Action if excluded
Urgent transfer to the BGH by ambulance or
discussion with medical staff if in the BGH.
As the benefit of a single dose of aspirin may
outweigh the risks in many situations for any patient
excluded the nurse should contact a doctor and
record their advice if the drug is to be administered
while awaiting an ambulance
Action if declines
The nurse must discuss the patient with a doctor
and refer patient if willing. Document fully all
discussions.
Interactions with
other medicaments
and other forms of
interaction
NHS Borders Aspirin PGD
 Aspirin and corticosteroids may enhance the
effects of aspirin on the gastrointestinal tract.
 Aspirin may enhance the effects of warfarin
and oral hypoglycaemics of the
sulphonylurea type.
 The toxicity of methotrexate may be
enhanced by concomitant use of aspirin.
Aspirin diminishes the action of uricosurics.
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3. Records- use designated recording form for MIU/OOH/ED. For ward
staff please record on kardex in the ‘once only’ section of the prescription
kardex and nursing notes. Ensure that all administrations are recorded.
a) The following records should be kept (either paper or computer based)
The GP practice, clinic, hospital, and ward or department
The patient name and CHI number
The medicine name, dose, route, time of dose
Drug batch number and expiry
The signature and printed name of the approved healthcare
professional that supplied or administered the medicine
The patient group direction title and/or number
Whether patient met the inclusion criteria and whether the
exclusion criteria were assessed
b) Preparation, audit trail, data collection and reconciliation
c) Stock balances should be reconcilable with receipts,
administration, records and disposals on a patient by patient basis.
Quantity supplied / received and current stock balance
d) Storage:- Store in a dry place below 25°C
4.
Professional Responsibility
 All Health Professionals will ensure he/she has the relevant training
and is competent in all aspects of medication, including contraindications and the recognition and treatment of adverse effects.
He/she will attend training updates as appropriate. For those
involved in immunisation, regular anaphylaxis updates are
mandatory.
 Nurses will have due regard for the NMC Code of Professional
Conduct, standards for conduct, performance and ethics (2008)
and NMC Standards for Medicines Management (2008)
5. References

British National Formulary (BNF) current edition
http://bnf.org/bnf/index.htm

Borders Joint Formulary (BJF)
http://intranet/new_intranet/microsites/index.asp?siteid=65&uid=1

SPC Aspirin Caplets 300mg www.medicines.org
NHS Borders Aspirin PGD
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Patient Group Direction for administration of aspirin 300mg tablets by
registered nurses employed by NHS Borders
This Patient Group Direction is approved for use by the under-signed :
Job Title
Name
Senior Doctor/Dentist
for relevant clinical
area
Ross Cameron
NHS Borders Director
of Pharmacy
Alison Wilson
NHS Borders Senior
Health Professional for
Clinical Area
Sheena Wright
Signed
Date
PGD AUTHORISED ON ……/……/……..
Signed by ADTC CHAIRPERSON: ………………………………………………..
Name: …John Hammond………..………………………………………………
The Health Professionals named below, being employees of NHS Borders are
authorised to provide and/or administer this medication under this Patient
Group Direction and agree to supply and/or administer this medication in
accordance with this Patient Group Direction
Name of Health
Professional
NHS Borders Aspirin PGD
Job Title
Signed
Date
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