Key is to recognize and treat shock early (before blood pressure decreases),
once child has signs and symptoms of shock, may have lost 25% of blood volume
BP not usually helpful sign of blood loss in pediatric patients
Can have high, low, or normal BP in shock
pulse pressure is helpful
80% of pediatric<unk> deaths associated with neurological injury (see pediatric head<unk> 
once child has signs and symptoms of shock, may have lost 25% of blood volume
Can have high, low, or normal BP in shock
pulse pressure is helpful
External
Internal
Thoracic cavity
Peritoneal cavity
Retroperitoneal space (i.e. pelvic fracture)
Femur fracture (into muscle/subcutaneous tissue)
Thoracic cavity
Peritoneal cavity
Retroperitoneal space (i.e. pelvic fracture)
Femur fracture (into muscle/subcutaneous tissue)
Trauma 
Standard trauma injuries plus:
Cold injuries
Child abuse
Drugs of abuse
SCIWORA
Head trauma 
Chance fracture