Critical Care Medicine

Abstract
The unbelievably rapid advances in the clinical sciences, especially in life-sustaining care, have impacted on medical practices to the point at which as much as one third of the hospital resources are devoted to the care of the critically ill and injured patient. Even the smallest of full-service hospitals is likely to have specialized facilities for critically ill or injured patients and for coronary care.1,2 Critical care medicine has emerged as a multidisciplinary service specialty, tightly allied with conventional disciplines, which include internal medicine,l surgery, anesthesiology, and pediatrics, as well as their subspecialties. The American Board of Medical Specialties has recently recognized that critical care medicine is a subspecialty of internal medicine, general surgery, pediatrics, and anesthesiology and has created mechanisms for subspecialty certification for critical care specialists.3 Critical care nursing has already evolved a prestigious certification process. See also p 1400. It is, therefore, appropriate that the