The current war has, like past conflicts, presented the medical community with opportunities to innovate novel approaches to old problems. Although trauma anesthesia is provided adequately in the majority of cases, a standardized approach for treating these complex and critically ill patients is lacking. While this technique was developed for anesthesia in non-permissive environments, the principles suggested here could serve as a template for trauma anesthesia in other environments as well. The algorithm is designed as a standardized protocol in an effort to simplify the approach to these complex patients who often present in a dynamic environment. A list of required equipment is included to serve as a guide for preparation prior to employment of the algorithm.