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A 14-year-old boy is transferred to the Teaching Hospital Karapitiya Emergency Treatment Unit (THK ETU) with fever and collapse. He is immediately triaged to a resuscitation bay and met by a team ofhighly skilled nursing and medical staff. He is found to be hypotensive, hypoxic and profoundly acidotic. A bedside ultrasound reveals bilateral pleural effusions and a large volume of free intraperitoneal fluid. He is managed as dengue haemorrhagic shock and within one hour multiple interventions have taken place. In this time, he is intubated, ventilated (to ARDS-NET principles) and has a central line. Hyperkalaemia has also been reversed, a blood transfusion and pressors have been commenced and intra-abdominal compartment pressures have been estimated. A paediatrician and renal physician have reviewed him and he is ready for transfer to an intensive care bed.

The delivery of emergency medicine at the Teaching Hospital Karapitiya emergency treatment unit – an Australian Perspective