Pediatric critical care is an emotionally and intellectually demanding field of medicine; however, it is at its core the discipline focused on saving and improving the lives of children affected by acute and chronic illnesses, injuries, and toxicities. The heart of any successful pediatric critical care program is the multidisciplinary and interdisciplinary care provided by pediatric intensivists and their team of specialized co-workers including pediatric critical care nurses, respiratory therapists, pharmacists, social workers, and nutritionists working in concert with the pediatric ICU (PICU). It is this interplay between clinical specialists that ensures children are afforded cutting-edge, technologically complex, holistic, and age-appropriate care, while at the same time ensuring that the needs of both the child and the family are addressed. Additionally, critical care medicine encompasses the extremes of all pediatric medicine and as such those charged with caring for children in the PICU must be well versed in all areas of pediatric medicine, as well as prepared for any contingency or emergency. Caring for sick children both within and outside of the pediatric intensive care unit (PICU) requires an understanding of how pediatric physiology differs from that of adults. Recognizing a deteriorating child and stabilizing that patient rapidly is a requisite skill that every clinician charged with caring for children must master. This practical handbook is written for all clinicians who care for children with acute illness, and who may need to assess and stabilize a deteriorating child before transfer to the PICU. Specifically, chapters provide helpful insights for all levels of pediatric providers including pediatric critical care and general care nurses, advanced practice nurses, medical students, pediatric residents, residents from other disciplines who rotate through PICU, pediatric hospitalists, and emergency physicians who care for children. In addition to covering PICU-specific topics such as mechanical ventilation and procedural sedation, this handbook also includes guidance in the initial resuscitation, management and stabilization of children with impending critical illness or those at risk for acute deterioration. Management of life-threatening situations that are specifically included in this book include respiratory failure, cardiovascular failure, electrolyte derangements, diabetic ketoacidosis, burn injuries, status epilepticus, status asthmaticus, toxic ingestions, and sepsis, among many others.