First 30 seconds
- 112-lead ECG within 10 min
- 2MONA-B (avoid O₂ unless SpO₂<94)
- 3Aspirin 300 mg PO chewed
- 4Ticagrelor 180 mg PO (or prasugrel/clopidogrel)
- 5Activate PPCI pathway
ST elevation ≥1 mm in 2 contiguous limb leads, ≥2 mm in V2–V3, or new LBBB.
A
Airway
- • Patent? Talking? Stridor?
- • Suction, jaw-thrust, adjuncts, definitive airway if needed
B
Breathing
- • RR, SpO₂, auscultate, percuss
- • O₂ to target sats, NIV / intubate as required
C
Circulation
- • HR, BP, cap refill, JVP
- • 2× large-bore IV, bloods, monitor, ECG
D
Disability
- • AVPU/GCS, pupils, glucose, temp
E
Exposure
- • Full exposure, skin, rash, bleeding, lines, infection source
