“-ibs and -abs”
Dr Sally Greenberg – Breast and General Oncologist
Immunotherapy – newest line of therapy, “check point inhibitors”
Toxicity: immune mediated inflammation of ANY system, 60% of patients (transaminitis and rash are most common)
Management:
- exclude other causes
- stop the drug
- antibiotics (cover infection as differential)
- steroids or immunosuppressant in emergency
Oncology Emergencies
Spinal cord compression
Febrile neutropenia – antibiotics within 1st hour! (Tazocin +/- vancomycin)
Delerium
SOB – multiple causes, consider immunotherapy pneumonitis
Tumour lysis syndrome
Metastatic does not mean dying!
Palliative intent – early referral to palliative care services improves quality of life and prognosis
Peter Mac “SMART CLINIC” – letters are available n “correspondance” section on BOSNET
Journal Club
http://jamanetwork.com/journals/jama/article-abstract/2598268
qSOFA – RR, mental status, systolic BP
useful for early identification of patients needing escalation of care – ie: ICU referral
Necrotising Fasciitis
Red flags:
rapidly progressive
pain out of context to signs
bullae, crepitus
Management:
early identification
referral to plastics/general surgery
antibiotics: clindamycin, meropenem, vancomycin
CVC insertion
Documentation
Ultrasound use
practice seldinger technique