The same lessons and strategies that have improved CPR are just as applicable to trauma management. Just as we have chosen to appropriately focus on correcting lethal arrhythmias in medical cardiac arrest, we need to choose which physiologic parameters in trauma patients we are going to target and then focus all of our resuscitative efforts to improving how we address those variables. To do this we need to understand what is happening to our patients, how we identify what is going on, and then how we treat it. When we decide what we want to treat, then we can focus on how we do that better. This has significantly improved outcomes in medical cardiac arrests. This presentation will focus on the key physiologic parameters underlying trauma resuscitation with a particular focus on the role of correcting oxygen debt. We also look at the other key parameters that can be rolled into high-performance trauma resuscitation including delayed-sequence intubation, calcium repletion and hypothermia management