Project Description: This project is funded by the Centers for Disease Control and Prevention (CDC) through the National Association of Chronic Disease Directors (NACDD). This is a two year project which began on December 15, 2008 and is scheduled to end on September 30, 2010. This project has four primary goals. First, is to assure that the EMS Stroke Care Toolkit is in use by all 100 EMS Systems with an evaluation of user experiences. Secondly, incorporate an existing EMS Stroke Recognition online educational program into the EMS Stroke Care Toolkit. Additionally, through this project, the effectiveness of the EMS Stroke Care Toolkit will be evaluated based on pre and post Toolkit performance indicators over a 12 month period. Lastly, this project will bring the development of an unrestricted version of the EMS Stroke Care Toolkit, based on the National EMS Information System (NEMSIS) data exchange standard that can be used by EMS agencies anywhere in the nation.