Quote from Altra
We have a cath lab. About half of the STEMIs discovered in the field bypass the ER entirely -- if the cath lab can be ready then there's no need to stop in the ER.
For ER patients the meds given are ASA, Plavix/Effient, and a heparin bolus. Maybe morphine if the pain is intense. Maybe NTG for pain if accompanied by elevated BP.
Usually they've has ASA, NTG, and fentanyl in the field, but in the ED they'll get: metoprolol, Plavix or Effient, started on an Angiomax gtt. If still painful after meds in the field, they'll get morphine, Dilaudid, or fentanyl, whatever the doc orders.