This issue of Emergency Medicine Clinics, guest edited by Drs. John Greenwood and Tsuyoshi Mitarai in collaboration with Consulting Editor Dr. Amal Mattu, is dedicated to Critical Care in the Emergency Department. Topics include: Cutting edge acute ischemic CVA management; The current status of TTM post-cardiac arrest and early post-cardiac arrest optimization; Beyond MAP and lactate: Perfusion endpoints for managing the shocked patient; Resuscitative Ultrasound & TEE; Mechanical ventilation for hypoxemic respiratory failure; Mechanical ventilation strategies for the patient with severe obstructive lung disease; Acute Renal Failure and electrolyte management in the critically ill; Advances in emergent airway management in paediatrics; Non-ischemic causes of cardiogenic shock; Critically ill patients with End-Stage Liver Disease; Intracranial Hemorrhage and intracranial hypertension; Sedation & Analgesia in the Critically Ill; Extubating in the ED; and Geriatric Critical Care.