Since the prevalence of acute coronary syndromes is still growing, a valid tool for risk stratification in the setting of emergency medical services is essentially. The synopsis from anamnestic data, physical examination and 12-lead ECG, estimates the total risk. Based on a pre-hospital triage-protocol, the decision about the subsequent clinical treatment can be made more reasonable. Low-risk-patients can be admitted to the next hospital with an internal division. Medium-risk patients should obtain ICU-Care. High-risk-patients must be admitted to a facility which performs PCI immediately.