Child 3 years old with short history of fever, shaking and generally unwell.

ED Triage assessment:
High temperature, he looks flushed, no rash, unwell child.

Ten minutes later– ED SHO:
Febrile child, listless, irritable and drowsy.
Temp 39.7, HR 170, RR 55.
Pyrexial and drowsy: ? cause, refer to paediatric team.