Patient name XYZ age 10 years old admitted in spoke hospital with complaint of Fever and Drowsiness. He had history of RTA (Road traffic accident) on 14th October with both lower limb bone fracture and liver injury. The patient was managed by the critical care command Centre and the nurses and Doctors of spoke ICU. We put the patient on mechanical ventilation for airway protection. On further examination, he was found to have Dengue NS1 positive with multiple organ dysfunction (liver, brain, kidney involvement). His blood clotting factors were also deranged. He received all organ supportive management along with blood products transfusion. His blood culture showed bacterial growth (Enterococcus faccium) for which he received culture guided antibiotics. Slowly he responded to management and started to improve the conscious level so team from eNext-ICU extubated on 28th October and organs also began to improve. Further patient was on supportive management for another two to three days and successfully shifted from ICU on 1st November. This case highlight, how Tele-ICU can be effective in treating these patients in Tier 2 and Tier 3 cities.