In the treatment of a suspected myocardial infarction, which action should be taken first?

• A. Call 999 urgently
• B. Administer aspirin
• C. Keep casualty sitting upright to assist breathing
• D. Begin BLS and defibrillation if necessary

Answer: (A)

The urgency in suspected myocardial infarction is getting professional help on the scene as fast as possible. Activating emergency medical services immediately ensures a trained team arrives with ECG capability, can start appropriate prehospital treatment, and transports the patient quickly to hospital for definitive reperfusion therapy. This time-critical step is what most improves survival and reduces heart muscle damage, so it should be done first rather than delaying for other actions.

Once emergency help is on the way, you can consider giving aspirin if there are no contraindications and the person can safely chew it. Aspirin helps by reducing further clot formation, and giving it early can improve outcomes, but it should not delay calling for urgent medical care.

Keeping the casualty upright to aid breathing might seem helpful, but it isn’t the priority when first responding. The main focus is to get EMS involved and monitor the person while awaiting arrival. If the person becomes unresponsive or stops breathing, start basic life support immediately and use an AED if one is available.