The challenge of managing seriously injured patients encompasses an expanse of issues linked by a common factor – trauma. In these critical situations, anesthesiologists are often faced with the need to simultaneously address emergent airway management, resuscitation, massive blood loss, acidemia, coagulopathy, hypothermia, and the consequences of damage to various organs. The management of each of these conditions alone can be essential for survival, and their convergence presents a unique situation in which the likelihood of death or a bad outcome is real. Success in this stressful situation requires a sophisticated understanding of basic sciences and expertise in the clinical and technical skills of anesthetic management. Together, the anesthesiologist and trauma surgeon must orchestrate the human and physical resources of the trauma center with a patient's life on the line.

Recent advances in the field of trauma anesthesiology parallel those in other related medical disciplines. Concepts promulgated by experiences in recent military conflicts have affected resuscitation and the use of blood products. The adoption of damage control operations and the use of simultaneous surgical teams to address multiple critical injuries have improved survival. Rules regarding the transfusion of blood and blood components and the use of recombinant clotting factors such as Factor VII concentrate have led to a “sea change” in trauma management that has resulted in the survival of soldiers and others injured under war conditions beyond what was possible just a few years ago. These concepts have been readily adopted in civilian trauma centers.