Footnotes

• Competing interests: None.

• ↵i On scene: airway management, oxygen therapy (± assisted ventilation), rapid transfer to hospital. En route: IV or intramuscular benzylpenicillin, treat shock with IV crystalloid boluses, identify and treat hypoglycaemia, provide hospital alert message including patient’s age.

• ↵ii Defined as: cardiorespiratory decompensation; raised intracranial pressure (signs include fluctuating or impaired levels of consciousness, focal neurological signs or abnormal posturing, dilated or poorly reactive pupils, relative bradycardia and/or hypertension, papilloedema (although this may not be present initially despite significantly raised intracranial pressure)); coagulopathy; or purpura/petechial rash.