Children form a significant proportion of accident services’ clientele but have received relatively little attention in the growing ethnographic literature on such organizations. This paper uses data from observation and interviews in four English accident departments to review Jeffery's influential analysis of medical staffs categorization of patients. After pointing to certain logical difficulties with this account, it is argued that an analysis of the way children are treated allows for these to be remedied by the development of a more sophisticated model of professional decision-making. The paper concludes with a discussion of the way in which the categorization rests on the practical contingencies of accident work and the social organization of emergency work. Attention is drawn to the variation between high-prestige units in teaching hosp pitals and lower-status units in general hospitals and the way this limits the ability of the former to identify conditions like child abuse or neglect.