The following ECG is from a 60 year old lady with chest pain and dyspnoea a few hours after finishing a triathlon. At the scene she was hypothermic at 32 degrees.

On arrival to ED she has no chest pain but ongoing dyspnoea and her temperature has normalised.

This is her initial ECG, what are the key abnormalities and how will you manage the patient?

With thanks to Dr Lorna Cronin for ECG and answer.