A patient presents with crushing chest pain and ST elevations on ECG. What is the priority action?

• A. Call the patient’s family.
• B. Activate STEMI protocol and administer aspirin if not contraindicated; notify the cath lab.
• C. Begin rehydration with IV fluids.
• D. Order a chest X-ray.

Answer: (B)

When someone has crushing chest pain with ST elevations on ECG, the situation is a STEMI, meaning a blocked coronary artery needs immediate reperfusion to save heart muscle. The priority action is to activate the STEMI protocol and give aspirin as soon as possible if there’s no contraindication, and notify the catheterization lab for urgent PCI. Aspirin helps prevent further platelet aggregation and clot growth, reducing mortality, while emergent PCI (via the cath lab) restores blood flow quickly and is the most effective reperfusion strategy when available. Actions like calling the patient’s family, starting IV fluids, or ordering a chest X-ray don’t address the urgent ischemia and can delay reperfusion, which is why they aren’t the priority in this moment.