Polites SF, et al. - Researchers ascertained if requirement of more than one fluid bolus predicts the need for transfusion in pediatric trauma patients. From prospectively maintained trauma databases, they identified the 2010 to 2016 highest tier activation patients younger than 15 years from two ACS Level I pediatric trauma centers. Findings revealed that following two crystalloid boluses, nearly half of pediatric trauma patients with elevated shock index require transfusion and the odds of requiring a transfusion plateau at this point in resuscitation. Thereby supporting the consideration of blood with the second bolus in conjunction with shock index.