Transcript Document

Acute Oncology Service
(Insert relevant service name)
Northern England Strategic
Clinical Network
The Network serves a population of
approximately 3 million and aims to
offer the highest quality, equitable care
to all patients in a seamless and
accessible pathway.
Regional Acute Oncology protocols and
guidelines that underpin our regional
and local services are available at:
http://www.nescn.nhs.uk/group/net
work-acute-oncology-group/
MSCC Centres
NCCC, Freeman Hospital
James Cook Hospital
Radiotherapy Centres
NCCC, Freeman Hospital
James Cook Hospital
Key features of an Acute
Oncology Service
•
Early review by an oncologist or oncology nurse specialist (within
24 hours)
•
24/7 access to telephone advice from an oncologist
•
Fast track clinic access from A&E
•
Access to information on individual patients across the Trust
•
Protocols for management of oncological emergencies and referral
pathways from A&E and acute admissions unit
•
Specific pathways for the investigation and treatment of malignant
spinal cord compression
The Acute Oncology Service is intended for ACUTE problems.
It does not replace existing pathways for the diagnosis of new
cancers or their planned treatment.
Key features of an Acute
Oncology Service
Patient Management
•
Review within 24 hours
oncology nurse specialist
•
24/7 access to telephone
advice from an oncologist
•
Protocols for management of
oncological emergencies
•
Investigation and treatment
of malignant spinal cord
compression
Referral Guidelines
• During and after treatment,
patients and GPs are advised
to contact the treating
hospital.
• Attend local A&E department
with immediate life
threatening complications
• Fast track outpatient clinics
post A&E acute review via the
site specific/acute oncology
team.
24 /7 patient advice line
All patients are issued with
an alert card with 24 hour
helpline number
(Insert number)
The chemo unit will
rehearse situations with
patients to ensure that
they understand when and
who they should contact if
they have a problem
All calls are followed up by
the acute oncology service
Management of suspected
Neutropenic Sepsis
Immediate Interventions
Empiric antibiotics immediately
•Isolate patient, perform and record
observations.
Do NOT wait for the neutrophil count
before starting antibiotics
•Establish venous access, bloods for FBC,
U&Es, LFTs, Coagulation, CRP, lactate and
blood cultures
•
Piperacillin/Tazobactum 4.5g given IV
stat.
•
Penicillin allergy – rash only
Meropenam 1gm IV.
•
Penicillin allergy – anaphylaxis
Ciprofloxacin 400mg IV plus
Teicoplanin 400mg
•IV fluids / oxygen if required
•Check for allergies
•Swabs for infection screen.
•Stools for culture & C Diff toxin if has
diarrhoea.
•Urine for culture if indicated.
In normal hours Monday – Friday (add in the details of how to contact your
service
Information pack for patients
Known cancer patient (aware of risk)
Discharge
Rehab Centre
(local unless
otherwise agreed)
Patient attends GP
Cancer patient unaware of
the risk (undiagnosed)
Transfer patient to
Centre for
definitive
treatment
Co ordinator
(collate clinical information)
Admission via A&E or Medical Admissions Unit
MRI
local /central
Coordinator link with local /
centre Oncologist
Oncology /
Surgery
patient
discussion
Supportive /
Palliative care
Key worker
Routine O.P. appt.
Discharge
Ward patient
Member of
Primary Care
Team
GP informed (+/- D.N. /
Primary Care Team)
Not Appropriate for
admission / active
treatment
Key worker
EOL
Add in details of how to contact your out of hours service
Known cancer patient
(aware of risk)
Discharge
Coordinator reviews log next
working day
Cancer patient
(unaware of the risk)
SPR Review
(Newcastle)
clinical information
with on call
Consultant
Oncologist
Patient contacts Primary Care
Log call
Admission via A&E or Medical
Admissions Unit
Consultant
Oncologist / SPR
on Call
(at Centre)
Transfer
patient to
Centre for
definitive
treatment
Ensure MRI
completed local
/ centre
Joint Oncology /
Surgery patient
review
Supportive
&
Palliative
Care
Record clinical
information
Ward patient with or
without a known
cancer
Rehab Centre (local
unless otherwise
agreed)
+/- review with
patients Oncologist
Key worker
Discharge
EOL
The Acute Oncology Assessment and
Consultant on call service
Available (add in details of local service)
•Acute oncology specialist nurse bleep (add in local contact)
•Access to consultant oncologist advice and assessment if needed
Telephone advice is available from an on call specialist registrar or
consultant oncologist, 24 hours a day, seven days a week via the
NCCC at FRH 0191 233 6161 or JCUH
(delete as appropriate)
24 hour advice from (add in local information)