Large Vessel Occlusion Stroke (LVOS) is an indication for activating stroke team. IR will be on board and this is level IA recommendation from 2015 AHA/ASA Guideline. The Field Assessment Stroke Triage for Emergency Destination (FAST-ED) extracted from NIHSS. LVOS were defined by total occlusions involving the intracranial ICA, MCA-M1, MCA-2, or basilar arteries. FAST-ED scoring system is based on NIHSS and has reliable accuracy to predict LVOS. FAST-ED will help to activate your stroke team from field and EMS will give you a score to determine this patient needs IR involvement as well as stroke team at bedside.