European Resuscitation Council guidelines for resuscitation 2005. Section 5. Initial management of acute coronary syndromes.

Pre-hospital recording of a 12-lead electrocardiogram (ECG) is recommended in patients with suspected ST segment elevation acute myocardial infarction (STEMI). For those with STEMI this expedites prehospital and in-hospital reperfusion and reduces mortality for both those planned for primary percutaneous coronary intervention (PPCI) and those who receive fibrinolytic therapy. Non-physician ECG STEMI interpretation with or without the aid of computer interpretation is suggested if adequate diagnostic performance can be maintained through carefully monitored quality assurance programs. Pre-hospital STEMI activation of the catheterisation laboratory may not only reduce treatment delays but may also reduce patient mortality. The use of negative high-sensitivity cardiac troponins (hs-cTn) during initial patient evaluation cannot be used as a standalone measure to exclude an ACS, but in patients with very low risk scores may justify early discharge.