An 8-year-old boy suffered a skull fracture and severe brain injury while attending a skiing event. A physician, equipped with his private emergency kit accomplished placement of a venous access line enabling administration of analgesic and sedating medication with ketamine and midazolam. When the helicopter emergency medical service arrived on the scene the patient's peripheral circulation had decreased to such an extent that further attempts to place a second peripheral venous line were impossible. Securing the airways by tracheal intubation was not considered necessary; the spine was stabilised with a cervical collar and a vacuum mattress. Transport to the trauma centre and intensive care were uneventful. The importance of a specially adjusted emergency kit for first aid by experienced medical personnel is discussed.