The chain of survival for a cardiac emergency and stroke start the same:1.  preparedness & recognition of an emergency; 2.  activation of EMS; 3.  delivery of Advanced Life Support; and 4.  transporting to the most appropriate facility. ALS ambulances are staffed with paramedics who have training in ACLS skills.  Why EMS "Destination Protocols" for suspected stroke and STEMI make a difference. ACLS’s timed benchmarks for: point of first medical contact to PCI for ST elevation MI;door to tPA for ischemic stroke; andonset of symptoms to EVT for LVO strokes.Why EMS should bypass a close hospital to transport a STEMI or suspected stroke patient to a hospital capable of 24/7 PCI or a certified stroke center. Check out the Pod Resource page at passacls.com for links to the "EMS On Air" podcast for links to episodes that look at EMS's role in stroke outcomes in the rural vs urban area.Connect with me:Website:  https://passacls.com@PassACLS on X (formally known as Twitter)@Pass-ACLS-Podcast on LinkedInGive back - buy Paul a bubble tea hereGood luck with your ACLS class!