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Hemorrhagic shock is a preventable mortality in pediatric trauma. Assessment and management requires an understanding of the patho-physiogical processes specific to children. The key to successful management of hemorrhagic shock in trauma is rapid assessment, appropriate intervention and frequent reassessment. Damage Control Resuscitation involves rapid identification and control of source of bleeding and timely and concise administration of blood products. Further pediatric studies are needed to understand the ratio of blood products to be administered and the impact of massive transfusion protocol in trauma.