Which of the following options represents a contraindication to aspirin administration under ICEMA standing orders?

• A. Recent aspirin use.
• B. Allergy to penicillin.
• C. Allergy to aspirin or active internal GI bleeding.
• D. Hypertension.

Answer: (C)

The key idea is identifying true safety barriers to giving aspirin in emergency standing orders. Aspirin is an antiplatelet, so it helps when a heart attack is suspected but it can cause harm if there’s already a bleeding risk or a known sensitivity. An allergy to aspirin means the patient could have a serious reaction, potentially life-threatening, if you administer it. Active internal GI bleeding means aspirin could worsen the bleeding and hinder clotting, making the situation much worse. These are absolute contraindications in this context.

Recent aspirin use doesn’t by itself prohibit administering aspirin; it may lead you to skip a second dose or adjust management, but it isn’t an outright contraindication. A penicillin allergy is unrelated to aspirin safety, and hypertension by itself does not prevent aspirin use in the standing orders.