This is the third special issue focused on the critically ill child and the content has once again been prepared mainly by members of the RCN Paediatric and Neonatal Intensive Care Forum. Writing the editorials for these issues provides us with an opportunity to celebrate the technological and nursing achievements in critical care, as well as to consider the challenges we face. For example, health inequalities are still a major challenge; the latest figures reveal that children from the poorest areas are more likely to be admitted to intensive care and the admission rate is 36 per cent higher for children from the south Asian population (Parslow et al 2008).