[First aid at the scene of the accident from the viewpoint of the trauma surgeon].

A step-by-step therapy concept for prehospital care of the severely injured is presented. A schedule for effective organization of the rescue procedure is given, after which stress is placed on preservation of the vital functions. A therapy algorithm is explained, according to which the indications for intubation, ventilation and volume replacement depend on both physiological parameters (blood pressure, respiration frequency, Glasgow Coma Scale, capillary refill) and the type of injuries. Initial care of the injuries is discussed in some detail. Competent preclinical management of fractures and joint dislocations is a major topic. A flow chart for the selection of an adequate trauma center is proposed, which takes account of vital signs, the extent of the injuries, how the accident happened, and the force of the impact.