The enclosed article is from the British Medical Journal . Health staff must rapidly assess, resuscitate and treat severely ill children to improve survival. Practical, simple to use protocols have been established to guide care. This study aimed to ‘evaluate the effects of intravenous fluid bolus compared to maintenance intravenous fluids alone as part of immediate emergency care in children with severe febrile illness and signs of impaired circulation in low-income settings. ‘
The findings included ‘robust evidence that in low-income settings fluid boluses increase mortality in children with severe febrile illness and impaired circulation, and this increased risk is consistent across children with severe and less severe circulatory impairment’.