This case describes the course of a severely injured child and demonstrates the advantages of service centralization in trauma care. A good outcome relies not only on rapid and targeted initial care, but also on a well-functioning care chain from the scene of the incident to discharge into the home environment. The care chain for severely injured individuals ends with full reintegration into everyday life. To achieve the best possible results, integrated and interface-free treatment paths are required. The emergency medical service (EMS) is at the beginning of the care chain and, in addition to quickly stabilizing vital functions, has the important task of paving the treatment path. This includes the most accurate possible assessment of the injury pattern and the selection of the target hospital. Early, precise communication with the target hospital is essential to enable appropriate preparations for admission. As part of the upcoming service centralization, we will have to prepare for long transport distances. For the EMS, this means that we must learn to focus on the essentials. On-scene times must be kept short and at the same time, intensive treatment must begin during transport to minimize secondary damage. However, the average German EMS physician sees hardly more than one severely injured person per year. This is not enough to develop or maintain the necessary expertise, and we must consider a reorganization of the EMS to meet the challenges.