Malaria sucks

So, most of the time malaria is easier than treating a cold.  Quick test, some tylenol and antimalarial medicines and you are on you way.  The last couple days really have sucked with sick kids from malaria.  I come back to the clinic from lunch and find mom holding a 3 year old in her arms that only responds to painful stimuli but starting to arouse.  He's been sick for a day and had a seizure about 30 minutes before.  His temp is only 38.9C but this is after the seizure and expected to be lower after the muscle activity.  He is sick and needs to go to the hospital but what to do before he goes.  His gag is good enough to get oral tylenol down but what if he has another seizure.  The saline IV drips I bought last time are gone and could do just an IV but reluctant to give any IV meds if he is being carried down the road.  Maybe I could give some IM diazepam to possibly prevent seizures on the way but there's no way to monitor him.  Does he have just a febrile seizure that happened because of rapid rise fever or perhaps cerebral malaria?  Perhaps both.  Shitty choices to make.  I give him the tylenol and tell the parent to get him to the hospital as quick as they can.

Most of the time this is fun, sometimes not so much.