You are evaluating a patient with a 15-minute duration of chest pain during transportation to the emergency department. He is receiving oxygen, and 2 sublingual nitroglycerin tablets have relieved his chest discomfort. He has no complaints but appears anxious. BP is 130/70 mm Hg. You observe the above rhythm on the monitor and your next action is:

A patient in the ED develops recurrent chest discomfort (8/10) suspicious for ischemia. His monitored rhythm becomes irregular as seen above. Oxygen is being administered by NC at 4 L/min and an IV line is patent. Bp is 160/96. There are no allergies or contraindications to any meds. You would first order:

A patient with an acute MI on a 12-lead ECG transmitted by the paramedics has the above findings on a rhythm strip when a monitor is placed in the ED. The patient had resolution of moderate (5/10) chest pain with three doses of sublingual nitroglycerine. BP is 104/70 mm Hg. Which intervention below is most important, reducing in-hospital and 30-day mortality?