During the last 30 yrs, there has been a remarkable reduction in severe TBI mortality from 50% to 25%. To ensure further improvement in TBI related mortality and to minimize related morbidity, formalization of further protocols to reduce delays in triage, transfer and treatment of patients should be implemented. Neurointensivists and Neurosurgeons have a long held belief that a decrease in the time between injury and definitive care improves the outcome. Early identification of intracranial hematoma in TBI patients allows faster triage and earlier surgical evacuation which is a robust determinant of outcome. The existence of serum biomarker testing and their availability as point of care tests in the scene or on route serves as a valuable adjunct to routine clinical examination and will aid in the most apt triage and cause-specific management decision making.