The pain is 8/10, tight/heavy in the centre of her chest, going down the left arm. Her initial observations are:

HR 105, RR23, SP02 93%, BP 83/35, Temp 35.4, Blood Sugars 7.3. She has no past medical history and takes no medication, no known allergies. Which of the following medications can be given within this scenario?

You confirm no contraindications and administer Aspirin while your colleague places on nasal O2 and the 12 lead. The limb leads are normal, but this is what you see in the V leads, what is your interpretation?

According to the ECG, which parts of the heart are being affected

On confirmation of an ST Elevated Myocardial Infarction (STEMI), what further medication can you administer within this scenario

You administer the clopidogrel and transfer the patient into the back of the ambulance and lay her on the stretcher. You raise her legs and start fluids administration. You repeat observations; HR 93, RR19, BP 105/64, SP02 96% on O2. With the change in observations what further medications can you now look to administer

You start with the GTN and carefully monitor the blood pressure to see if there are any changes. After a few minutes the blood pressure maintains and you administer a small amount of Morphine, titrating to the effects on the patients’ blood pressure. The patient advises that they are starting to feel sick. What medication can you consider to aid with the nausea

Depending on your location within the UK, different services still have Tenecteplase and Heparin for the management of Myocardial Infarction. What is the reason for this

You are on route to with the patient now. What is considered the optimal destination where available, for patient treatment