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What is What should be done If the patient cannot be transported to hospital immediately in the case of CARDIAC EMERGENCIES or  Acute Coronary Syndrome- Adult  and explain in detail?
If there will be a significant delay, i.e. more than two hours, in transporting patients with an acute coronary syndrome to hospital then it is appropriate to discuss the patient with an emergency medicine consultant or a cardiologist who may suggest additional interventions, if the required medicines are available. Patients presenting in rural areas are most likely to be considered for these additional treatments. Include the following information where possible: 1. Time of onset of symptoms and duration 2. Previous and current ECGs 3. Current blood pressure, heart rate and oxygen saturation levels 4. A list of any medicines given acutely, including time and dose 5. Co-morbidities 6. All medicines currently prescribed as well as any over-the-counter products 7. Allergies 8. Any relevant person details such as an advanced care plan 9. Any relevant family history Check immediately if chest pain is current, or when the last episode was, particularly if in the last 12 hours. Check if the chest pain may be cardiac. Consider: 1.  history of the pain 2. any cardiovascular risk factors 3. history of ischaemic heart disease 4.  any previous treatment previous investigations for chest pain. Initially assess people for any of the following symptoms, which may indicate an acute coronary syndrome: pain in the chest and/or other areas (for example, the arms, back or jaw) lasting longer than 15 minutes chest pain with nausea and vomiting, marked sweating or breathlessness (or a combination of these), or with haemodynamic instability new onset chest pain, or abrupt deterioration in stable angina, with recurrent pain occurring frequently with little or no exertion and often lasting longer than 15 minutes. Central chest pain may not be the main symptom. Do not use response to GTN to make a diagnosis of acute coronary syndrome. Do not assess symptoms of an acute coronary syndrome differently in men and women or among different ethnic groups. There are no major differences in symptoms of an acute coronary syndrome among different ethnic groups.