In the advanced nations trauma represents the third cause of death after cardiovascular diseases and tumours. Recently, great importance has been given to the need to treat traumas as quickly as possible in order to reduce mortality and morbidity. Prompt management of is the gold standard in the emergency setting and the phrase "golden hour" is now commonly used. The authors report on their experience with the management of multiple trauma, through the study of 617 clinical cases. Patients were evaluated with the Revised Trauma Score (RTS), Injury Severity Score (ISS) and Abbreviated Injury Scale (AIS). Of 420 (68%) cases of major trauma only one patient had ISS > 60. Patients were admitted on average after 47 +/- 18 min. Only two deaths occurred in the emergency unit. The task of the emergency unit is to stabilise the patients, anticipate the complications, including mainly shock and multiple organ failure, optimizing time, interventions and resources to reduce morbidity and mortality.