We report about the prehospital treatment of an 82-year-old man with septic shock as a complication of acute pancreatitis. Initially only an advanced life support ambulance was on scene. After the primary assessment, the team decided to call for an emergency-physician-staffed helicopter. Because of the long estimated time of arrival on scene, the paramedics had to stabilize the patient without the physician. Therefore, they requested telemetric support. Despite massive centralization and difficult circumstances, the team succeeded to stabilize the patient in ongoing consultation of the tele-emergency physician. This cooperation made immediate und uneventful transportation after arrival of the helicopter possible.