KEY POINTS Initial resuscitation should focus on rapid assessment and stabilization of life-threatening injuries with management of non–life-threatening injuries deferred until the patient is stabilized. Damage control resuscitation includes efficient intravenous access, avoidance of hypothermia, and a preference for colloid resuscitation rather than crystalloid. Providers should understand indications for both emergency intubation and discretionary intubation in the trauma setting as well as options when endotracheal intubation is not possible. Combining plain films, physical examination, and ultrasound allows for a complete cavitary triage to be performed and will identify nearly all hemodynamically significant sites of bleeding. Retrograde balloon occlusion of the aorta is likely beneficial in the profoundly hypotensive patient, but is not synonymous with resuscitative thoracotomy.