This document contains guidelines of when to transfer the critically injured and/or ill pediatric patient. The guidelines serve as a resource for hospitals in the State of Washington. The Washington Administrative Code for trauma recognizes a pediatric patient as one aged 14 years and under. It is noted that many pediatric patients in their early teens may be the size of a small adult which may prompt physicians and surgeons to keep them in their local facility. Caution is advised with this practice, as these patients still have emotional and physical needs akin to all children such as child life services as well as nurses and ancillary staff, trained to care for the pediatric patient. This document includes physiologic, anatomic, American Burn Association and other transfer criteria for trauma and non-trauma pediatric patients as well as guidelines for interfacility transport, locations of centers and an interfacility transfer check-list.