Description:

In this episode, an 11-year-old boy arrives unconscious, seizing, with a temperature of 40°C and tea-coloured urine. He was treated for malaria for four days. Now his kidneys are failing, his pressure is dropping, and the clock is running out.

In this real-life case review, Dr. Ann Kaguna Imelda (who managed the case) and Dr. Kenneth

Bagonza (EM expert) walk through every critical decision—what worked, what didn’t, and

why the child was unfortunate in the end.

special credit: Dr Daniel Oriba Longoya

Key points of discussion:

· The red flag triad

· Primary survey findings: threatened airway, shock, GCS 6

· Why dextrose has no role in septic shock resuscitation

· CSF Gram-positive diplococci = pneumococcal meningitis – treat immediately

· Managing hyperkalemia + AKI in a crashing child

· The 1-hour sepsis bundle (2026 guidelines)

· qSOFA at the bedside: RR ≥22, altered mental state, SBP ≤100 – no equipment needed

· Why “malaria not improving in 48 hours” demands a rethink

· Final reflection: system failures, early recognition, and what we owe the next child

Listen to learn. Share to save lives. Mastering Emergency Care

Disclaimer: For Educational Purposes only, refer to guidelines for definitive management

Show Notes & Resources:

· Watch the Full Case Video: https://youtu.be/qZZ86tknD8k?si=Pczbbe-vqvcti80V

· Rosen’s Emergency Medicine

· Tintinalli’s Emergency Medicine

· SSC 2026