Hi, interesting. I can't see any p's either so av block is questionable, you would still see the sinus node firing. maybe some kind of sinus dysfunction. I'm also in germany. I have seen epi given in some cases, not in others, mostly during syncopal episodes, but it can lead to a loss of micro-circulation, so is used sparingly. I work in a realtively small house now with a cathlab and we do temporary cables in the cathlab, at the university hospital i used to work at they did it in the icu. No st segment elevation i can see, but there may be prior disease of the rca. Would do an echo. I wouldn't give oxygen on a 94 sat, i think the guidelines state because of cardiotoxic oxygen free-radicals. If it fell then yes but if stable no. No compensatory BP spiking either, i dunno i think this is a dying heart. Would still try a pacer though see what happens.