The problems of improving care of life-threatened victims of accidents influence the organization, equipment and training of hospitals, staff and physicians. Our review of the helicopter rescue program at Frankfurt/Main, introduced in 1972, clarifies the following: Nearly 200 annual daylight sorties underline a strong demand for helicopter activities in the densely populated Rhein-Main area. Unnecessary dispatches were made only in 16% of calls. The helicopter is stationed near the city of Frankfurt/Main at the BG Unfallklinik, a department specializing chiefly in traumatic and orthopedic surgery. The surgeons of this department are well trained in emergency interventions. They are competent to make triage decisions. When necessary, endotracheal intubation, resuscitation, and infusion therapy are performed immediately.