Even the most seasoned veteran in the intensive care unit (ICU) can feel intimidated by a call from the emergency department announcing a new admission [horizontal ellipsis] who, by the way, is pregnant!! After the initial call, there is typically a flurry of communication regarding assigning the right room, identifying a nurse who has some obstetric experience, and ensuring that a "precip" pack is on the unit. Then everyone begins to focus on the special needs of the patient and the fetus. This issue of Critical Care Nursing Quarterly has been planned to help the staff become better equipped to deal with the pregnant patient in the ICU.

The initial article by Torgersen and Curran, "A Systematic Approach to the Physiologic Adaptations of Pregnancy," should be required reading for all nurses to refresh their understandings of the changes in body structures and processes that occur during pregnancy. "Critical Illness During Pregnancy: Considerations for Evaluation and Treatment of the Fetus as the Second Patient" by Simpson provides an excellent guide to ensuring that the unborn baby is well managed and protected during the mother's ICU stay. "Cardiac Disease in Pregnancy" by Arafeh and Baird and "Trauma During Pregnancy" by Tweddale consider 2 of the most common problems that critical care staff might encounter. The vital nuances of cardiovascular and respiratory support can never be overlooked, regardless of the admitting diagnosis. Witcher's "Promoting Fetal Stabilization During Maternal Hemodynamic Instability or Respiratory Insufficiency" is an outstanding article that equips the ICU nurse with the essentials for life support of the pregnant patient. Campbell and Rudisill provide important direction for the ICU staff in "Psychosocial Needs of the Critically Ill Obstetric Patient: The Nurse's Role." Finally, Franklin's work "The Neonatal Nurse's Role in Parental Attachment in the NICU" is the linchpin to address an essential component of the hospital critical care experience. Two unsolicited articles complete this issue. "Unmet Needs of Family Members in the Medical Intensive Care Waiting Room" by Browning and Warren and "Collaborative Development of an Insulin Nomogram for Intensive Insulin Therapy" by Fraser, Robley, Ballard, and Peno-Green are research-based, and provide valuable information for all of our readers.

Ensure that you add this issue to the library shelf on your unit. It should be required reading for every ICU nurse who may some day pick up the phone and learn that a new admission is on the way [horizontal ellipsis] and she is pregnant. This journal will provide both the information and the perspectives to ensure a successful venture in caring for pregnant patients in the ICU.

Judith H. Poole, PhD, RNC

Issue Editor, Presbyterian Healthcare, Charlotte, NC