This program utilizes rotational thromboelastometry, platelet impedance, evaluate patient plasma for markers and factors involved in the coagulation cascade. A current prospective observational trial is collecting specimens from pediatric trauma patients at initial hospital evaluation and 24 hours after admission to characterize the coagulation milieu in patients with different injury severity, injury patters, and coagulation abnormalities. A clearer understanding of differing mechanisms that exist between patients may allow us to evaluate potential for treatment options to improve outcomes especially in the patients with minor to severe head injuries, which currently accounts for a significant proportion of pediatric trauma morbidity and mortality.