This month’s issue features articles evaluating adverse events in the pediatric ICU (PICU) over a 10-year period, in-hospital cardiac arrests in adults admitted to PICUs, and disease severity trends of SARS-CoV-2 in U.S. PICUs. Two articles discuss prevalence and readmission rates of discharge directly home from the PICU. Other articles focus on goals of care and end of life, including different types of communication and prognostic statements, identification of medical complexity, and end-of-life issues in patients with ventricular assist devices. Additional clinical investigations and brief reports explore in situ simulation of a new critical care unit, pharmacokinetic modeling of midazolam and pentobarbital use in refractory status epilepticus, and the use of steroids in the general PICU population. Online review articles explore antimicrobial stewardship programs and strategies to reduce iatrogenic blood loss in critically ill patients.