• Coma (cerebral malaria): maintain airway, nurse on side, exclude other causes of coma (e.g. hypoglycaemia, bacterial meningitis)

• Intubate if necessary

• Hyperpyrexia: tepid sponging, fanning: give Paracetamol (not aspirin in this situation)

• Convulsions: treat as usual (see section on epilepsy in CNS disorders). Protect airway; ventilation may be needed

• Hypoglycemia: urgent and repeated blood glucose screening; dextrose 50% followed by dextrose 10% infusion should be given

• Severe anaemia: transfusion of packed cells if Hb < 6 g/dl

• Acute pulmonary oedema: review fluid balance and run patient on “dry side” but avoiding inadequate perfusion of kidneys; set up Central Venous Pressure (CVP) line, give oxygen

• Intubation/ventilation may be necessary

• Acute renal failure: exclude pre-renal causes, check fluid balance and urinary sodium. If adequately hydrated (CVP > 5 cm) try diuretics. Haemodialysis/haemofiltration should be started early in established renal failure.