Readily available information on pediatric perioperative transfusion equipment is limited. Recommendations often vary depending on the source of the information (e.g., commercial versus academic), and pediatric practitioner education about transfusion-related equipment is often not evidence based. Currently, there are no standardized pediatric guidelines for rapid infusion devices (RIDs), which have no place in neonatal resuscitation. The acceptable weight cutoff for RIDs in older children is unclear, although a body weight of 20 to 40 kg is often cited in the literature. When selecting vascular access for resuscitation, patient body size, available insertion sites, and the desired infusion rate must be considered. If rapid vascular access is critical but cannot be obtained, the intraosseous approach should be considered. Rapidly administered, large volumes of cold-stored blood should be administered through a warming device. A blood filter that can remove blood clots and macroparticles is required for all blood transfusions. There are many adverse events associated with the rapid transfusion of blood products to small patients. These include, but are not limited to, hyperkalemia, over-transfusion, hypocalcemia, and venous air embolism. The purpose of this case-based discussion is to touch on each of these topics critical to the safe and, when feasible, evidence based resuscitation of the bleeding child, with an focus on transfusion related equipment.