SUMMARYIt is essential to approach the patient with multiple trauma with a plan, which insures an adequate examination to rule out life-threatening injuries. Clinicians who are well schooled, disciplined and efficient in carrying out such a plan can increase patient survival. This was demonstrated during the Vietnam war when battlefield mortality was decreased to approximately 1% through on-site treatment and efficient management at the base hospital. An examination for less essential injuries may be carried out at the scene, in transit or upon arrival at the emergency department, contingent upon the time and conditions surrounding the patient's care.Management of the patient with multiple systems injury presents an unparalleled challenge to the emergency medical clinician. To give the best possible emergency treatment, assuring proper care of airway, ventilation, circulation and spinal cord must be the priorities.