The role that resuscitation plays in the care of the injured patient has become more apparent as the management of trauma matures in the context of lessons learned from the past decade of conflict in Iraq and Afghanistan. The prompt application of basic medical technologies like tourniquets have saved many lives on the modern battlefield, just as they did on battlefields of the past [1]. Refinements of trusted therapies like blood transfusion have improved outcomes, and rigorous investigations continue to define the margins for improvement in trauma resuscitation [2–4].

A perfect surgery performed on a poorly resuscitated patient is of no benefit. Similarly, aggressive resuscitation without equally effective surgery is also a failure. The role of the anesthesiologist in resuscitation defines the trauma anesthesiologist. Procedural fluency, while required for the anesthesiologist, should not limit the specialty to a purely technical role. Anesthesiology is no more defined by (or limited to) endotracheal intubation than the specialty of critical care is defined by ventilator management. Trauma Anesthesiology combines a thorough understanding of the pathophysiology of acute illness with the interplay of anesthetics during an on-going resuscitation; there is no currently available physician specialist training program that incorporates the appropriate elements to accomplish this goal.

The emergency physician understands the challenges inherent in the diagnosis of undifferentiated disease and the pathophysiology of the critically ill patient under physiologic stress (e.g., trauma, sepsis). The emergency physician’s intervention as the first physician responder for many trauma patients is integral to the continuum of care for these patients; appropriate primary care defines the subsequent hospital course and outcome.

A combined residency in anesthesiology and emergency medicine can incorporate and supplement the strengths of these two specialties to manage patients along the continuum of resuscitative and definitive care. As medical practice continues to find more resources outside traditional medical constructs (e.g., mid-level providers, on-line resources), physician consultants must provide a “value added commodity.” The resuscitation expert will consult on patients in the emergency department, manage their medical care in the OR/IR suite, and coordinate their ongoing management in the ICU. The future of physicians in hospital-based practices will be defined by their capacity to rescue, manage, and coordinate care across a wide spectrum of diseases and environments of care.