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You are evaluating a 48 y/o male with crushing sub-sternal pain. He is cool, pale, diaphretic, and slow to respond to your questions. BP

You are evaluating a 48 y/o male with crushing sub-sternal pain. He is cool, pale, diaphretic, and slow to respond to your questions. BP is 58/32, pulse is 190/min, resp rate is 18, and you are unable to obtain an 02 sat due to no radial pulse. The ECG shows a wide complex tach rythm. What intervention should be next?

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