6th March 2024

A 68-year-old gentleman is brought in by ambulance to A&E in the middle of the night with a 2 hour history of central chest pain moving to the left arm.

A 68-year-old gentleman is brought in by ambulance to A&E in the middle of the night with a 2 hour history of central chest pain moving to the left arm. He has received 300mg of aspirin and GTN spray from the paramedic which settled the pain. His ECG in the ambulance showed no acute changes.  His background includes smoking, high BMI, diabetes and a family history of MI. While the nurse is taking blood, he complains of chest pain. Repeat ECG shows ST elevation in the inferior leads. The closest primary PCI centre is 1 hour away. What is the most important next step to take?

Select the SINGLE most appropriate option from the list below. Select ONE option only.