Traumatic brain injury (TBI) is a potential high-risk condition, but appropriate care pathways, including prehospital triage and primary referral to a specialized neurosurgical centre, can improve neurological outcome and survival.

The care pathway starts with layman triage, wherein the patient or bystander decides whether to contact a general practitioner (GP) or emergency services (1-1-2 call) as an entryway into the health care system.

The GP or 112-health care professional then decides on the level of urgency and dispatches emergency medical services (EMS) when needed.

Finally, a decision is made regarding referral of the TBI patient to a specialised neurotrauma centre or a local hospital.

Recent studies have shown that injuries are generally more severe in patients entering the health care system through EMS (112-calls) than through GPs; however, no information exists on whether mortality and morbidity outcomes differ depending on the referral choice.

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