The management steps taken during the critical period condition the survival and posterior morbidity of trauma patients. Life should take priority over function and this over aesthetics. The primary survey is the key to detect and treat life threatening injuries. Definitive treatment is nearly always hospital based and therefore transfer should not be delayed. The absence of a definitive diagnosis should not impede the application of therapeutic measures. Psychological suffering and pain should not be left unattended and the principle of primum non nocere should always be taken into account.