The MICN or research assistant will identify study subjects. A study investigator will review the log on a weekly basis to ensure no patient is missed. Patients will be eligible for enrollment in the study if they are identified by paramedics as having a STEMI and transported to a study site. The patient will be identified by the MICN or research assistant at the time of base contact or arrival to the hospital with a prehospital diagnosis of STEMI. Patients will be excluded if they are under 18 years of age, if the primary complaint is trauma, if they are in cardiac arrest at the time of paramedic arrival or if they are transported to a non-study site.