This presentation discusses the management of trauma related symptoms in pediatric patients using a case-based approach. In the United States, injury is the #1 cause of mortality in children ages 1 to 18. There are significant differences with pediatric trauma patients not only physically, but in physiologic responses to injury and medications, as well as behavioral and psychosocial needs. The use of a multimodal approach for various domains of pain allows providers to manage symptoms while minimizing pharmacologic burden.