The scope of respiratory and ventilatory support offered in the emergency department (ED) has expanded substantially in the last 10 years. Emergency physicians are now much more aggressive and sophisticated in their management of bronchospasm, pulmonary edema, and acute respiratory failure. New medications and new technologies that have been tested in intensive care units should also be considered appropriate for use in the ED; indeed, from a respiratory support standpoint, the ED should be viewed as an intensive care unit. In this article, the authors outline these new concepts and treatments that allow initiation of "intensive care" in the ED.