Eh up Aled, Assuming you're a UK MR team member (I think I recognise your name) I would suggest it depends on the area you cover. First thing to say is remember Oxygen/Nitrates/Aspirin in MI. The pain is ischaemic so anything that gets more oxygen through will help both the pain and the MI. Working in the Peak District, our transport times to hospital are quite short in MR terms. I would therefore suggest it is rarely appropriate to use IM morphine in our environment. The blog people tell me we are now friends - will e-mail. Good choice of topic Mr Reynolds. Interesting discussion.