The use of mild hypothermia after OHCA due to VF in adults has been associated with improved neurologic outcome and is generally tolerated without any significant complication Current AHA recommendations are to begin targeted temperature management with a consistent goal of between 32° and 36°C for all adult patients after arrest who remain comatose, regardless of presenting rhythm or location of arrest (though recommended in those patients with initial shockable rhythm from OHCA and suggested for all other populations) Data from large, multicenter, randomized controlled trials have demonstrated that therapeutic hypothermia for asphyxiated newly born infants ≥36 weeks’ gestation can reduce death and neurologic disability when initiated within hours of birth AHA guidelines recommend that all such infants with moderate to severe hypoxicischemic encephalopathy be offered therapeutic hypothermia However, the data for pediatric patients is less clear Recent large, randomizedcontrolled trials of targeted temperature management found no difference in neurologic outcome between hypothermia (32° to 34°C) and normothermia (36° to 37.5°C) Current AHA guidelines state that either targeted temperature management to normothermia (36° to 37.5°C) for days, or hypothermia (32° to 34°C) for days followed by days of normothermia may be considered for children who remain comatose after return of spontaneous circulation following cardiac arrest Fever adversely affects recovery from ischemic brain injury, and should be treated aggressively; avoiding temperatures of 38°C or higher is recommended QUALITY IMPROVEMENT EDs represent a high-risk environment for the medical care of patients due to factors such as clinical uncertainty, frequent interruptions, and the need for haste Children are at particular risk in emergency care because of their physical and developmental vulnerabilities, their inability to accurately describe symptoms or past medical history, the complexity of weight-based treatment, and the relative discomfort of some providers in treating pediatric patients This risk is particularly heightened during emergency resuscitation, which is a teamdependent and information-intensive process of rapidly treating acute life- and organ-threatening diseases The medical resuscitation environment is especially prone to medical errors due to its fast-paced, complex environment Therefore, ongoing surveillance of resuscitation events is vital; with an eye toward process and system changes which can support the resuscitation team, minimize distraction from patient care and maximize protocol adherence A video review process in which all resuscitation events are video-recorded, and a subset is