It is now more than ten years since the publication of the first edition of Textbook of Paediatric Emergency Medicine and interest in this specialty continues to grow at a local and international level. Paediatric emergency medicine can be a challenging and difficult area for doctors. Children cannot always communicate their problems verbally, while parents are anxious and the possibility of a missed diagnosis is ever present. Although the principles in managing paediatric patients are the same as adults there are significant differences in patterns of illness and response. In addition, the therapies available vary widely between adult and paediatric practice.