ED Pathway for the Evaluation/Treatment of the Oncology Patient with Fever
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RN/MD/CRNP Rapid Assessment
RN line access and labs
MD order for labs
Consider need for stress Hydrocortisone
(except for CART-19 pts - call Oncology ASAP)
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Microbiology Reviews
MD Orders/Labs

Further diagnostic testing
Bed request
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  1. Cefepime
  2. Vancomycin
  3. Gentamicin
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Oncology Consult
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Any of the Following:
  • Broviac
  • BMT < 6 Months ago
  • BMT w/ Active GVHD
  • Known ANC < 200 in
    Previous 24 hrs
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  1. Cefepime
  2. +/- Vancomycin
  3. Gentamicin
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Oncology Consult
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Ceftriaxone
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Neutropenia
  1. Gentamicin
  2. +/- Vancomycin
Without
Neutropenia
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Oncology
Consult
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Neutropenia
  1. Cefepime
  2. +/- Vancomycin
  3. Gentamicin
Without
Neutropenia
  •    No Treatment
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Oncology
Consult
Posted: February 2008
Revised: November 2011, December 2012, January 2014, March 2014
Authors: B. Ku, MD; A. Reilly, MD; C. Jacobstein, MD; J. Lavelle, MD; L. Kersun, MD