Appreciate what you're saying Jr Doc however doing an ecg there and then in the back of an ambulance shows what's happening/happened and then further ecgs illustrate potential changes. Even if no changes occur then the receiving hospital can see that. But, if you do not do an ecg then one can not see if there are/are not any changes. Whether the run to hospital be 5 minutes or 50 minutes. And, yes a paramedic can do something parked in a GP surgery car park because they can thrombolyse IF the patient fits the criteria and consents to such a treatment. The only way to know is by looking at a 12-lead ecg. And, when living a long way from a hospital taking the time to do such a thing allows (conditions allowing) for the crew to call on the helicopter which will take the chap/chapess to hospital in less than 15 minutes. Any observations done by the initial practitioner (doc/paramedic/joe public) will be of great bonus not only to the attending ambulance crew but to the patient themselves. The more advanced the equipment the better. Wherever possible, crews will do what is possible in a moving vehicle. Aside from the jobs of the military, treating a patient in a moving ambulance is one of the riskiest jobs one can do.