Damage control surgery (DCS), in the context of major trauma, is a critical step in the management of uncontrolled haemorrhage and requires expedient transfer to the operating room (OR). Communication and leadership within the trauma OR represent significant challenges due to time pressures, changing personnel, real or perceived hierarchy, and environmental factors including personal protective equipment (PPE). We discuss the wider implications of managing trauma within the OR and the difficulties in managing newly formed teams. By highlighting transferrable solutions including, but not limited to, building a positive team culture, regular team training, closed-loop communication, and regular situation reports and briefing, we hope teams can make the best use of their time and existing skills. These are valuable tools to enhance leadership and communication while mitigating the deleterious effects of transferring trauma patients through multiple teams during their hospital stay.