Objective: To describe the frequency and proportion of successful resuscitation interventions in a pediatric emergency department (PED). Methods and Material: This was a retrospective chart review of children at the BC Children's Hospital (BCCH) PED who were admitted to the BCCH pediatric intensive care unit (PICU) in 2004 and 2005. Demographic data, diagnosis, and resuscitation interventions in the PED and within the first 24 hours of PICU admission were recorded. The training of the operator and the number of attempts needed were also recorded. Results: There were 75,133 PED visits; 304 of 329 (92.4%) who met inclusion criteria were reviewed. Diagnoses included respiratory distress (n 5 115, 35%), trauma (n 5 50, 15%), sepsis (n 5 36, 11%), seizures (n 5 37, 11%), and cardiac disease (n 5 22, 7%). Ninety-nine patients required intubation. Intubations in the PED were performed by residents (20%), pediatric emergency medicine (PEM) fellows (15%), PEM attending staff (29%), and PICU fellows (12%); 81% of these were successful on the first attempt. In the PED, seven central lines were placed, seven intraosseous needles were inserted, 15 patients required inotropes, and 9 patients required chest compressions. Conclusion: Critical illness in our emergency department is a rare event; hence, opportunities to resuscitate, secure airways, and place central venous catheters are limited. Additional training, close working relationships between the PED and the PICU teams, and resuscitation protocols for early PICU involvement may be needed. RÉ SUMÉObjectif: Dé crire la fré quence des manoeuvres de ré animation et le taux de succè s dans un service des urgences pé diatriques (SUP). Ré sultats: Il y a eu 75 133 visites à l'urgence des soins pé diatriques; 304 des 329 visites (92,4 %) ré pondant aux critè res d'inclusion ont é té analysé es. Les diagnostics comprenaient : dé tresse respiratoire (n 5 115, 35 %), traumatismes (n 5 50, 15 %), sepsis (n 5 36, 11 %), convulsions (n 5 37, 11 %), et maladie cardiaque (n 5 22, 7 %). Quatre-vingt-dix-neuf patients ont né cessité une intubation. Les intubations au SUP ont é té ré alisé es par les ré sidents (20 %), les moniteurs cliniques (fellows) en mé decine d'urgence pé diatrique (15 %), les mé decins traitants du SUP (29 %), les moniteurs cliniques à l'USIP (12 %). Le taux de succè s de ces intubations à la premiè re tentative é tait de 81 %. Au SUP, 7 cathé ters centraux et 7 abords veineux intra-osseux ont é té mis en place, des inotropes ont é té administré s à 15 patients et des compressions thoraciques pratiqué es chez 9 patients. Conclusion: Des cas de maladies graves sont rares à notre service d'urgence. Les occasions de pratiquer des manoeuvres de ré animation, d'ouvrir les voies aé riennes et de poser un cathé ter central sont donc limité es. Il faut envisager une formation supplé mentaire, des relations de travail é troites entre les é quipes du SUP et de l'USIP et la mise en place de protocoles de ré animation pour une intervention pré coce de l'USIP.