An essential aspect of the care of the critically ill patient is to identify cardiovascular insufficiency, treat it, and know when to stop over resuscitation while also attending to the various other aspects of pathology that each patient brings to the clinical environment. No two patents are alike in their presentation of acute illness, response to therapy, or potential for a good outcome from the treatment of disease and a minimal amount of treatment-associated morbidities. Furthermore, most people, if they live long enough, will experience some acute, potentially life-taking, process that if not treated correctly and rapidly will result in death or morbidity before their time. These realities make the practice of critical care medicine one of the most demanding of all medical specialties, and one of its greatest attractions in the recruitment of dedicated and passionate bedside clinicians.