# Aspirin

Adult suspected cardiac ischemia and the limits of pediatric and fire-service use.

Population: Adult & pediatric guidance. Scope: ALS.
Status: published. Source-linked OCEMS summary.
Summary updated: 2026-09-16.
Source checked: 2026-09-16.
Source version: I-15 revised March 31, 2026; I-20 revised March 26, 2026. Both implemented April 1, 2026. See linked condition-specific sources..
Canonical page: https://www.ocmedic.com/guides/aspirin/
Official source: [I-15 — Adult / Adolescent Standing Order Drug Guide](https://www.ochealthinfo.com/sites/healthcare/files/2026-04/I-15%20Adult%20SO%20Drug%20Guide%2004-2026.pdf)

Independent OC Medic summary. Does not replace the complete policy, current system notices, or clinical judgment.

## Check before giving

- SO-C-015 withholds aspirin for reported allergy, anticoagulant/antiplatelet medication use, or direct midline mid-back pain suggesting possible aortic dissection.
- Apply the OCEMS contraindications as written; a general cardiac guideline from another jurisdiction may differ.

## Source documents

- [I-15 — Adult / Adolescent Standing Order Drug Guide](https://www.ochealthinfo.com/sites/healthcare/files/2026-04/I-15%20Adult%20SO%20Drug%20Guide%2004-2026.pdf#page=1)
- [I-20 — Pediatric Medication Volume Dose by Weight](https://www.ochealthinfo.com/sites/healthcare/files/2026-04/I-20%20Peds%20Drug%20Guide%2004-2026.pdf)
- [SO-C-015 — Chest Pain of Suspected Cardiac Origin or Suspected Angina Equivalent Symptoms](https://www.ochealthinfo.com/sites/hca/files/2021-07/SO-C-15%20updated.pdf)
- [SO-F-02 — Over the Counter (OTC) Medications](https://www.ochealthinfo.com/sites/hca/files/import/data/files/60122.pdf)

## Use in OCEMS

- The 9-1-1 standing-order indication is adult/adolescent chest pain of suspected cardiac origin or an anginal equivalent.
- Obtain a 12-lead promptly; a normal tracing does not exclude serious ischemia.

## Adult / adolescent

| Indication / route | Dose & limits |
| --- | --- |
| Suspected cardiac chest pain | Four 81 mg tablets (324 mg total) or one 325 mg tablet, once. SO-C-015 instructs the patient to chew. |

## Pediatric

- A pediatric cardiac aspirin regimen is not provided in I-20. Do not scale down the adult chest-pain dose or present adult standing-order authority as pediatric authorization.
- Use the applicable pediatric assessment and base-directed care when cardiac disease is suspected.

## Pediatric dosing availability

- No routine pediatric field regimen is supplied by the cited OCEMS sources; do not scale an adult dose by weight.
| Weight | OCEMS pediatric dose |
| --- | --- |
| Any weight | No general pediatric dose under the cited source; follow the applicable order / medical direction. |

## Preparation & reassessment

- Ask specifically about medications already taken and document the amount administered.
- SO-F-02 separately lists aspirin for eligible firefighting personnel using package directions through an FS-ARN program; that is not a general pediatric or ALS dosing pathway.