A wide range of surgical methods is available in the intensive care of patients with a chest trauma. Discussions with the anaesthetist as to the planning and co-ordination of diagnosis and treatment must take into consideration a great number of factors. The indications for surgery in polytraumatized persons are different from those that apply to single injuries. Table 6 which lists the cause and time of death of 52 persons with multiple injuries provides evidence that during the first 7 days after a severe accident all surgical intervention that is not absolutely necessary should be avoided and attention focused on the problem of adequate ventilation and primary and secondary complications of shock.