Em basic- heme Onc Part 1- oncology Emergencies

EM Basic- Heme Onc Part 1- Oncology Emergencies

(This document doesn’t reflect the views or opinions of the Department of Defense, the US Army or the SAUSHEC EM residency, © 2015 EM Basic, Steve Carroll DO, May freely distribute with proper attribution)

Neutropenic fever

-Patients present to the ED because they have been instructed to come to the ED for any fever

-Definition of “fever” for neutropenic fever

-Oral temp of 100.9 F (38.3 C) or higher on a single measurement

-Oral temp of 100.4 F (38.0 C) that persists for one hour

-If temp is borderline or patient had subjective fever, should still likely pursue the workup

PEARL: NEVER take a rectal temperature or do a rectal exam on a patient on chemotherapy. Due to being immunocompromised they are at high risk of gram negative sepsis from the mucosal trauma from rectal temps or exams
Vital signs- pay attention to triage temperature, any tachycardia or hypotension that could suggest sepsis
Triage note- new port? Temp at home? How many days since last chemo?