The coronavirus disease 2019 (COVID‐19) pandemic has placed large stressors on emergency departments (EDs) worldwide. As the pandemic progressed, EDs faced changing patient epidemiology and numbers. Our ED needed to rapidly transform to deal with the risk of COVID‐19. Having limited floor space, we opted for a phased, dynamic response that allowed us to adapt the ED multiple times as the epidemiology of the pandemic evolved. The principles behind our response include guiding ED operations with data, enhancing infection control practices, and being prepared to transform areas of the ED to care for different groups of patients. Our experience can serve to guide other EDs in planning their response to surge capacity and ED operations during such pandemics.

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There have been numerous advancements in the management of ST-elevation myocardial infarcts (STEMI) for the last few decades. Studies have shown an improvement of survival of STEMI due to increased use of perfusion therapy and recommended medications. The success of timely reperfusion therapy for STEMI patients would require close collaboration between pre-hospital care, emergency medicine, and cardiology departments to address the processes and professional issues in the various stages of management. This article reviews the latest management methods and issues, both pharmacological as well as reperfusion strategies. The different phases of emergency care for STEMIs were examined and various strategies for achieving rapid diagnosis and to improve door-to-balloon or door-to-needle time were discussed. Reperfusion methods of percutaneous coronary interventions and fibrinolysis were reviewed. Current evidence on adjuvant pharmacological therapies such as anti-platelet, heparin, anti-thrombin inhibitors, nitrate, b-blockers, and angiotensin-converting enzyme inhibitors were reviewed and examined.

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