Dave AndersonMay 14, 2024

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.

Show threadjacobianMay 14, 2024
@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
Show threadDave AndersonMay 14, 2024
@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".
Show threadjacobianMay 14, 2024

@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.

Show threadDave Anderson

@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.

May 14, 2024 at 8:55pmWeb
Show threadjacobianMay 14, 2024
@danderson my WFR is super old so I just double checked and you’re right - NOLS now recommends 320 daily for suspected heart attack.
Show threadDave AndersonMay 14, 2024
@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?...
Show threadDave AndersonMay 14, 2024
@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.