Emergency department response to the pediatric trauma patient starts with the basics–ABCDE. Certain important differences in pediatric patients, such as airway physiology and drug dosing, must be considered but standardized resources are available. Pediatric blunt and penetrating trauma treatment also have mechanisms and nuances that distinguish them from adult cases. Pediatric literature is slowly growing which can shape evidence-based practice for care including blood transfusions, medications, and procedures.