Abstract [American College of Emergency Physicians: Emergency ambulance destination. Ann Emerg Med July 1999;34:128.] The American College of Emergency Physicians (ACEP) believes that patients who are transported under the direction of an EMS system should be taken, whenever possible, to a hospital facility that meets the Emergency Care Guidelines 1 of ACEP. If an area does not have a hospital facility that meets the Emergency Care Guidelines, the EMS system physician medical director may designate an alternate medical facility to receive patients by ambulance. ACEP recommends that such alternate medical facilities meet the Emergency Care Guidelines of the College. The EMS system physician medical director 2 should have the authority to establish transport protocols that address the needs of both the patient and the local EMS system. These protocols must be closely monitored to ensure optimal and appropriate patient treatment is provided.