The care of severly injured patients is a major task in trauma. Due to a high mortality, especially in the first 24 hours after the accident, and morbidity of these patients, a structured assessment according to the ABCDE algorithm (ATLS®) is necessary. After life-threatening injuries are excluded, further injuries can be sought and treated. The timing and extent of these treatments depends on pathophysiological criteria, the injuries and the planned interventions. In the presence of negative predictors, only shortened procedures, so-called «damage control surgery», should be used. The definitive care is provided after a phase of stabilization and normalization of these pathophysiological values (body temperature, pH, coagulation). This is followed by a rehabilitation with the aim of re-integration.