Why Critical Care Evolved METs? In early 2004, when Dr. Michael DeVita informed me that he was cons- ering a textbook on the new concept of Medical Emergency Teams (METs), I was surprised. At Presbyterian-University Hospital in Pittsburgh we int- duced this idea some 15 years ago, but did not think it was revolutionary enough to publish. This, even though, our fellows in critical care medicine training were all involved and informed about the importance of "C- dition C (Crisis)," as it was called to distinguish it from "Condition A (Arrest). "We thought it absurd to intervene only after cardiac arrest had occurred, because most cases showed prior deterioration and cardiac arrest could be prevented with rapid team work to correct precluding problems. The above thoughts were logical in Pittsburgh, where the legendary Dr. Peter Safar had been working since the late 1950s on improving current resuscitation techniques, ?rst ventilation victims of apneic from drowning, treatment of smoke inhalation, and so on. This was followed by external cardiac compression upon demonstration of its ef?ciency in cases of unexpected sudden cardiac arrest. Dr. Safar devoted his entire professional life to improvement of cardiopulmonary resuscitation. He and many others emphasized the importance of getting the CPR team to o- of-hospital victims of cardiac arrest as quickly as possible.

This new edition provides an accessible account of the essentials of intensive care medicine. The core of the book focuses on areas common to all critically ill patients including fluid therapy, sedation, shock, infection and other central topics. This key understanding of basic pathophysiological principles provides an excellent launch pad for the section on individual disease entities encompassing haematology, gastroenterology, nephrology, endocrinology, the respiratory system, cardiovascular pathology, poisoning and neurology. Economic and ethical issues are also covered, and the text is supported by numerous problem-oriented guidelines to help the care provider tackle real-life practical problems as encountered in the ICU. In the same spirit, wherever possible, the authors provide precise and meaningful advice, rather than bland generalisations. This new edition reflects the excitement, challenges and uniqueness of intensive care medicine, for the benefit of all residents, trainees, nursing staff and paramedics attached to the ICU.