INDEX

Neutropenic Fever

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Protocol

There is a specific protocol for patients presenting to the ED with possible neutropenic fever. For aid in recognition, these patients are instructed to present cards to triage when they arrive to the ED, though staff should be mindful of recognizing possible neutropenic fever without the card.

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  1. When a patient with possible neutropenic fever is identified in triage, and a room is not immediately available, the patient should be isolated and an ED physician should be called to evaluate.

  2. Labs, cultures and broad spectrum antibiotics should not be delayed. Have a low threshold to initiate the UED Sepsis PowerPlan. For presumed or confirmed neutropenic fever, antibiotics should be administered within 1 hour of arrival.

  3. Disposition is similar to other oncology patients presenting with sepsis and the patient’s stability will determine the level of care for admission. A MASCC score is sometimes used in low-acuity patients to assess whether an outpatient management or short observation is reasonable. This should be done in coordination with the Oncology fellow.

 

MASCC Score

KEYWORDS: neutropenia