Immediate treatment

Whoever sees the patient first, whether it be emergency room staff, the general practitioner, or paramedic, needs to relieve pain, generally with nitrates and an opiate (plus an antiemetic), give oxygen (since arterial desaturation is usual), and give half to one tablet of oral aspirin to be chewed for a rapid antiplatelet effect (since platelets are hyperaggregable in acute myocardial infarction). An ECG can be recorded while this is being instituted in order to make a decision about reperfusion therapy in the initial 15 to 30 min after arrival at the hospital. Telephone or radio transmission of the results of an ECG obtained outside hospital or in transit to the coronary care unit or emergency room can save valuable time.

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