Combined injury, or polytrauma, involves more than one physical injury, which may consist of exposure for toxic chemicals and trauma injury. Intoxications and trauma injuries are usually considered separately, which may lead to inadequate life-saving measures during an event including both chemical injuries and physical trauma. Consequently, there is a need of improved knowledge how to manage individuals with combined injuries. The aim of this report is to describe complications when chemical and physical trauma injuries are combined, such as patient management in the medical chain, choice of medical treatment and execution of skin decontamination. The study has been a collaboration between the Division of CBRN Defence and Security at the Swedish Defence Research Agency, and the unit for Experimental Traumatology at the Karolinska Institute. The conclusions are: 1. Develop, educate and exercise simple differential diagnostics for chemical and physical trauma injuries to enable identification or exclusion of combined injuries 2. Include both injury types in the same triage algorithm including life-saving interventions to facilitate medical decisions and to avoid mistakes in the management of combined injuries. 3. The choice of available specific skin decontamination products should be based on the possibility to use the product both on intact skin and in wounds. This would facilitate the management of combined injuries and shorten the time to discontinued chemical exposure. If decontamination cannot be performed on open wounds, procedures for packaging contaminated skin should exist. 4. When providing prehospital medical treatment it should be considered that treatments may interfere with symptoms of intoxication which can make symptom interpretation more difficult. The available pharmaceuticals at the incident scene should be chosen based on knowledge that certain drugs become inefficacious due to other ongoing treatments and that trauma treatment may aggravate symptoms of intoxication.