Hybrid ER system is an all-in-one trauma-bay which equipped CT scan, angio-suite and operation room. This system introduced more than ten institutes in Japan. Twenty-five-year-old male jumped from 8th floor and brought up to our department with pulseless electrical activity. His right arm was amputated. He was resuscitated with vital signs and CT was taken safely. CT revealed sever traumatic injury, bilateral pneumothracies, right lung contusion and traumatic pneumatocele. For primary survey and secondary survey with CT scan finding, it took about 30min. Hybrid ER system is an option to reduce the time from door to definitive care.