Perioperative preparation for emergency patients is paramount, as it entails a comprehensive approach to ensure the safety, well-being, and successful outcomes of individuals facing urgent surgical interventions. In the preoperative phase, rapid but essential steps are taken, such as assessing the patient’s medical history, conducting diagnostic tests, and stabilising their condition to minimise risks during surgery. So in this chapter, we will discuss the importance of formation of the multidisciplinary team, efficiency improvements, identifying the need for emergency department (ED) to operating room (OR) Handoff Standardisation, and integration of ED nurses into the OR. It begins by establishing the criteria for identifying patients needing urgent surgery, encompassing traumatic injuries and acute medical conditions. It extensively covers the interdisciplinary collaboration required among ED staff, OR teams, anaesthesiologists, surgeons, and nurses. The scope includes patient assessment and stabilisation procedures conducted in the ED, focusing on diagnostics, interventions, and life-saving measures. Furthermore, the chapter delves into handoff protocols and communication strategies, highlighting their crucial role in ensuring safe and efficient patient transfers. It addresses resource allocation, emphasising the optimisation of operating rooms, equipment, and personnel. The chapter also acknowledges the importance of patient and family engagement, stressing clear communication, informed consent, and emotional support.