This publication of the second edition of Critical Care Nursing of Infants and Children is another important milestone in the evolving development of pediatric critical care nursing. It often surprises students and colleagues when I discuss my experiences in the days "before pediatric intensive care units." They cannot conceive of a time when these specialized units, along with their highly technologic treatments, were not available to facilitate the care of critically ill children. During this "before" period, seriously ill children were cared for on regular hospital units with minimal technology. Staff nurses were often assigned to "special" the child, unless the family provided a private duty nurse. Sometimes a separate room was set aside for care of several seriously ill children so that one nurse could care for several children. The level of expertise of these staff and private duty nurses, however, was not adequate for the intensive care needs of critically ill children. Obviously children with serious health problems or children recovering from major surgery were at high risk of dying because adequate treatments and monitoring measures were not available.