Cocaine associated myocardial infarction should be managed in a manner similar to other patients with acute coronary syndrome, except that beta blockers should not be used and benzodiazepines should be administered early. The treatment itself may have complications. If attempts to restore the blood flow are initiated after a critical period of only a few hours, the result may be a reperfusion injury instead of amelioration. Wilderness setting In wilderness first aid, a possible heart attack justifies evacuation by the fastest available means, often meaning the initiation of a MEDEVAC. The suspicion or provisional diagnosis of an MI means that it is inappropriate for the patient to walk out of the wilderness setting and will require them to be carried or conveyed in a vehicle. Aspirin, nitroglycerin, and oxygen can all be given with relative ease in a wilderness setting and should be administered as soon as possible in suspected cases of MI. Wilderness management of cardiac arrest differs slightly from that carried out in an urban setting in that it is generally considered acceptable to terminate a resuscitation attempt after 30 minutes if there has been no change in the patient's condition. Air travel Certified personnel traveling by commercial aircraft may be able to assist an MI patient by using the on-board first aid kit, which may contain some cardiac drugs (such as glyceryl trinitrate spray, aspirin, or opioid painkillers), an AED, and oxygen. Pilots may divert the flight to land at a nearby airport. Cardiac monitors are being introduced by some airlines, and they can be used by both on-board and ground-based physicians. References Selected cited works Aging-associated diseases Cardiovascular diseases Ischemic heart diseases Medical emergencies Cardiac procedures