Trauma is the leading cause of morbidity and mortality in children aged over 1 year. Whilst the management of children after trauma follows the same principles as adults, there are unique features of pediatric trauma. The patterns of injuries are different in children of different ages. Children have a large head, making them prone to head injury, but also prone to upper cervical spine injuries rather than the lower cervical spine affected in adults. Head trauma tends to cause diffuse, axonal injury and cerebral edema rather than focal collections. The relatively flexible tissues of children allow great force to be transmitted internally, and there can be significant injury in the chest or abdomen with few external signs. Once injured, a child can compensate for significant blood loss and maintain a relatively normal blood pressure, before sudden decompensation and cardiovascular collapse. Children are also prone to burns—scalds in young child, flame burns in older children. Children with large burns are prone to hypothermia and hyponatremia during fluid resuscitation, and quickly become catabolic after their burn.