Experiences from accidents show that the majority of critical injuries die within the first 1-4 h if they do not receive some appropriate medical treatment. The problems of an accident with many casualties is dealt with by: (a) maximum utilization of resources; and (b) sorting the tasks.

By rapid and skillful evaluation, we may sort out the critical injuries and give priority for treatment and transport. Through experience we have learned the few and very simple principles of dealing with critical injuries: (a) rapid and sufficient first-aid at the scene, (b) rapid evacuation to a hospital, (c) efficient final treatment, and (d) the need for an effective system of communication between the scene, the ambulances and the hospital.

The principle objective of medical first-aid on the scene of an accident is to stabilize the patient and to make him fit for transportation. Only thereafter is the most necessary temporary treatment carried out. The resuscitation must be continued during transportation. Qualified personnel with equipment must accompany critical injuries. During the last decades there has been a considerable development in the first-aid on the site. Each wounded individual must get the maximum benefit. This requires a high degree of field administration and co-ordination of medical activity on site. This may differ from country to country, but in general the principles will be the same.