Bypassing the emergency department for resuscitation of the most severely injured patients has long been advocated. Rapid transport systems combined with the instant availability of OR facilities and trained trauma teams markedly decreased morbidity and mortality among these patients. 2. In many institutions, the resuscitation operating room is in the OR suite; others have built an operating room in the emergency department. The most radical approach is a self-contained trauma facility, complete with operating rooms, separate from the emergency department. 3. Awareness of priorities, continuous assessment and revision of priorities, defined roles, and multidisciplinary cooperation are important. Reduction of inventory and simplification of instrumentation are essential for a fast response.