There's a lot of interesting research on paramedics vs emts (I believe the term of art is basic life support vs advanced cardiac life support). In areas where there is a good ER, it's better to have low level basic life support and break the sound barrier to the ER than do significant intervention on site but slow arrival at the hospital, as far as I am aware.

There is a chain of things that need to be done

- early recognition - early administration of aspirin and/or nitro if indicated - activation of, and transport to, a hospital with catheterization capabilities.

If medics can show up and do multiple ekgs to confirm and en route, thats even better. But critically the blockage needs to cleared, and they need definitive care (cath lab).