Although decisive changes have been made in the past ten years by re-organizing and improving pre-hospital care, emergency measures at the scene of the accident still require special emphasis in accident victims with head injuries concerning the recognition and treatment of vital complications. The success of these measures depends on the time interval for their initiation, on the practical skill and expertise of the person administering life support, and the availability of equipment.

An emergency examination at the scene of the accident is absolutely essential for correct assessment and should reveal imminent failure of arrest of vital functions. This can be achieved by using the rescuer's five senses and does not require special diagnostic equipment. An initial sign that cerebral trauma has occurred can often be recognized by a superficial injury to the skull during an initial orientation examination, although some of the most severe closed craniocerebral injuries can occur without the slightest superficial sign of trauma.