In the case of severe wounds and polytrauma, the risk of surgery depends on many factors. Some factors are more definite, while others may arise or be revealed during the intervention. Thus, their unpredictability is especially pronounced, predetermining an extreme situation of risk, extreme situations of extreme necessity, and extreme situations of forced experiment. The research aims to study the organizational and methodological aspects of resolving intraoperative extreme situations using the integration of artificial intelligence (AI) to mitigate and identify modifiable risk factors. The research processed data on the injury’s nature, the shockogenicity of the injury, the degree of risk based on the injury characteristics, mortality in victims in extreme situations, and the length of stay of deceased victims in the hospital. Based on the study of the organizational and methodological aspects of solving extreme situations for victims when providing surgical and resuscitation assistance to victims in an extreme situation, the authors formulated certain recommendations. In extreme situations, a close intraoperative collaboration of surgeons and anesthesiologists-resuscitators is necessary, perceived in unity as a surgical team with the common goal of mastering the system of joint assessment of extreme situations and making collegial and competent decisions on its correction.