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This document is a response to a letter regarding the impact of prehospital care and door-to-computed tomography scan time on stroke outcomes. The authors address the issues raised by the letter and provide information about the prehospital assessment and care of stroke patients in Ireland. They explain that Ireland has a standardized training protocol for paramedics, and all hospitals can receive pre-notification of suspected strokes from ambulances. They also mention that technical solutions like mobile stroke units have not been extensively assessed in remote areas due to cost and low frequency of use. The authors conclude that optimizing prehospital and emergency care for stroke patients is important, but there is no evidence that patients attending remote hospitals in Ireland receive poorer care in these respects. [Extracted from the article]