Trauma anaesthesia management is a challenge because we must deal with a critical ill patient with unclear history, injuries and physiologic status. ATLS® protocol is a useful tool in assessing and managing patients with complex and life threatening injuries. Rapid sequence of intubation is the preferred approach for airway control. Many factors combine to increase tracheal intubation difficulty in the trauma patient. Fluid management is especially challenging because of rapid, unpredictable changes in volume status and incomplete pre-operative resuscitation. For severely injured, the damage control resuscitation approach is intended to minimize exacerbating the multifactorial trauma-induced coagulopathy by replacing lost blood with plasma and platelet-containing products (haemostatic resuscitation) instead of using early and large amounts of crystalloids and RBCs (hypotensive resuscitation). This strategy encapsulates also the established concept of damage control surgery in the scope to rapid control the haemorrhage.