The guidelines follow the priorities established by the A-B-C-D-E scheme. They focus on the treatment of actual disturbances of vital functions and not so much on their anticipated development. Important recommendations with regard to the indication for intubation and ventilation, fluid therapy, diagnosis and treatment of severe chest injuries (tension pneumothorax in particular), management of severe traumatic brain injury, pelvic and vertebral injuries, priorities in the management of extremity fractures as well as indications for the choice of the receiving hospital are given. The recommendations are discussed in view of future concerns and developments.