Primary percutaneous coronary intervention is the method of choice for reperfusion in the setting of acute coronary syndrome with ST elevation (STEMI). According to the guidelines, it is necessary to provide as many patients as possible with the opportunity of interventional treatment, even those living far from PCI capable hospitals. Every region in Croatia should develop a clear protocol for patients with acute coronary syndrome in whom primary PCI is indicated, while relying on already existing networks of healthcare providers. Therefore, the application of telemedical communication systems is useful, since it allows confirmation of the diagnosis by a specialist of internal medicine or cardiology and enables communication between physicians on the spot and physicians at a district hospital or PCI capable hospital. In order to save time, it should be attempted to transport the patient directly to the PCI capable hospital, skipping district hospital. The transport of the patient with the acute coronary syndrome is generally safe if safety protocols are followed: an educated attending healthcare professional, ambulance with required equipment and use of appropriate procedures of prehospital treatment.