Prehospital trauma care is a very controversial area. The system used in the USA by paramedics is based on the 'scoop and run' theory, which considers prehospital advanced trauma life support to be a waste of time. In many European countries, on the other hand, advanced trauma life support is mandatory. The question of which of these systems is the better remains a issue of debate. In common with all complex medical controversies there is no straightforward answer; the best system of prehospital trauma care is probably not limited to either of these extremes.