In a recently published letter to your journal, Dr Gray and his colleagues criticised the newly published algorithm for the treatment of meningococcal disease and septic shock in children.1 2 In particular, they were concerned that the “sole trigger” for intubation was 60 ml/kg of fluid resuscitation. This is not the case. The algorithm indicates that after each bolus of fluid, the child should be assessed for “signs of shock”. Further, we are concerned that the authors’ recommendations for timing of intubation may result in fatal delays. In the …