In this video, orthopaedic trauma surgeon Derek Donegan, MD, offers the big picture for the emergent care of massive polytrauma. Through a presentation to first responders, Dr. Donegan reviews in detail the case history of a patient brought to Penn’s Level 1 Trauma Center at Penn Presbyterian Medical Center following a high-impact vehicle collision. Here, he describes the goals of treatment, the importance of teamwork, and each step of the effort to stabilize the patient, address the most urgent needs and avoid the mortality of the “second hit” in the days after traumatic injury.